阴股沟皮瓣在修复女性尿生殖三角区恶性肿瘤切除术后皮肤软组织缺损中的临床应用  

Clinical application of pudendal thigh flap in repairing skin and soft?tissue defects in the female urogenital triangle after excision of malignant tumors

作　　者：王维楠 张健[1] 白玉丹[1] Wang Weinan;Zhang Jian;Bai Yudan(Department of Dermatologic Surgery,The Seventh People's Hospital of Shenyang,Shenyang 110003,China)

机构地区：[1]沈阳市第七人民医院皮肤外科,110003

出　　处：《中华皮肤科杂志》2020年第10期816-817,共2页Chinese Journal of Dermatology

摘　　要：目的探讨阴股沟皮瓣在修复女性尿生殖三角区恶性肿瘤切除术后皮肤软组织缺损中的临床应用。方法对2015年1月至2017年12月沈阳市第七人民医院皮肤外科收治的10例女性尿生殖三角区恶性肿瘤患者(乳房外湿疹样癌7例,鳞状细胞癌3例)行肿瘤Mohs显微描记扩大切除,术中采用以阴部内动脉穿支血管为蒂的穿支皮瓣(其中单侧8例,双侧2例)修复外阴缺损创面。结果10例患者,12个皮瓣全部成活,其中2例切口有轻度感染,经换药完全愈合,其余切口均一期愈合。术后随访6个月至1年,患者外阴部形态丰满,富有弹性,阴道口无狭窄,瘢痕无明显挛缩,肿瘤无复发。结论以阴部内动脉穿支血管为蒂的阴股沟皮瓣修复女性尿生殖三角区皮肤软组织缺损效果较好。Objective To investigate clinical application of pudendal thigh flap in repairing skin and soft tissue defects in the female urogenital triangle after excision of malignant tumors.Methods From January 2015 to December 2017,10 female patients with malignant tumors of the urogenital triangle(7 cases of extramammary eczematoid carcinoma and 3 of squamous cell carcinoma)received peripheral Mohs micrographic surgery in Department of Dermatologic Surgery,The Seventh People′s Hospital of Shenyang.During the surgery,the pedicled internal pudendal artery perforator flaps were used to repair vulvar defects in 8 patients with unilateral defects and 2 with bilateral defects.Results Among the 10 patients,all the 12 flaps survived;2 patients developed surgical wound infections,but received complete healing after wound dressing change,and the other 8 patients all received primary healing of incisions.After 6 months to 1 year of follow-up,the vulvas were plump and highly elastic in all the patients,with no narrowing of the vaginal opening,obvious contractures of scars,or recurrence of tumors.Conclusion The pudendal thigh flap pedicled on the internal pudendal artery is markedly effective for repairing skin and soft tissue defects in the female urogenital triangle.

关 键 词：修复外科手术 外科皮瓣 会阴 佩吉特病 乳腺外 肿瘤 鳞状细胞 

分 类 号：R739.5[医药卫生—肿瘤]