肋间后动脉背侧穿支螺旋桨皮瓣在上背部瘢痕疙瘩手术治疗中的应用  

Propeller DICAP Flaps for the Treatment of Keloids in the Upper Back Areas

作　　者：吴东翰 冯少清[1] 许恒 喜雯婧 章一新[1] WU Donghan;FENG Shaoqing;XU Heng;XI Wenjing;ZHANG Yixin(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科杂志》2020年第4期284-287,共4页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：国家自然科学基金面上项目(81772098);上海市科学技术委员会优秀技术带头人计划(18XD1423700);上海市教委高峰高原计划—“研究型医师”项目(20152227);上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队建设(2017-1-007);上海交通大学医学院附属第九人民医院临床研究助推计划(JYLJ027)。

摘　　要：目的探讨肋间后动脉背侧穿支(Dorsal intercostal artery perforator,DICAP)螺旋桨皮瓣应用于背部大面积瘢痕疙瘩切除后创面修复的治疗效果。方法回顾分析2015年6月至2019年6月的4例上背部瘢痕疙瘩患者,瘢痕疙瘩切除后遗留创面均应用DICAP螺旋桨皮瓣修复,术后24~48 h创面及供区均行早期放射治疗。结果对4例患者共成功实施6个DICAP螺旋桨皮瓣修复,供区均直接关闭。未出现皮瓣部分/完全坏死,仅1例术后出现血清肿。平均随访21.2个月,均未出现瘢痕疙瘩复发。结论DICAP皮瓣联合术后早期放疗是躯干上背部瘢痕疙瘩手术治疗的有效可行的方法。Objective To investigate the therapeutic effect of the propeller dorsal intercostal artery perforator(DICAP)flap in repairing wounds after large-scale keloid resection on the upper back.Methods Four cases of patients with upper back keloid from June 2015 to June 2019 were retrospectively analyzed.DICAP propeller flap was used to repair the wound after keloid resection,and early radiotherapy was performed on the wound and donor site 24-48 hours after surgery.Results Six flaps were performed in 4 patients.All the flaps were performed successfully and the donor sites were closed directly.There were no partial/complete flap necrosis.Seroma was observed in 1 case.All patients were followed up for 21.2 months on average,no patient suffered keloid recurrence.Conclusion DICAP flaps combined with early postoperative radiotherapy provide an effective and feasible strategy for the surgical treatment of keloids in the upper back.

关 键 词：肋间后动脉背侧穿支皮瓣 螺旋桨皮瓣 瘢痕疙瘩 放射治疗 

分 类 号：R619.6[医药卫生—外科学]