V-Y推进式背阔肌肌皮瓣在胸壁缺损创面修复重建中的临床应用  

Clinical application of extended V-Y latissimus dorsi myocutaneous flap in the reconstruction of chest wall defects

作　　者：卢璐 刘家祺 朱明 张汝凡 陆南杭 杨燕文 陈诚 顾建英 亓发芝 张勇 Lu Lu;Liu Jiaqi;Zhu Ming;Zhang Rufan;Lu Nanhang;Yang Yanwen;Chen Cheng;Gu Jianying;Qi Fazhi;Zhang Yong(Department of Plastic and Reconstructive Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院整形外科,上海200032

出　　处：《中华整形外科杂志》2022年第2期138-142,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨V-Y推进式背阔肌肌皮瓣在胸壁缺损创面修复重建中的临床应用效果。方法选择2016年1月至2018年12月复旦大学附属中山医院整形外科收治的胸壁缺损患者的临床资料纳入研究。患者均应用V-Y推进式背阔肌肌皮瓣进行修复重建,术后门诊随访6个月以上,观察有无皮瓣血供障碍、伤口愈合不良、术区积液等并发症及有无肿瘤复发。结果共纳入16例,男6例,女10例,年龄28~78岁,平均54.8岁,胸壁软组织缺损创面面积为10 cm×15 cm~19 cm×26 cm。术后1例皮瓣远端三角区静脉回流障碍,1例出现皮瓣部分伤口裂开,2例背部血清肿,2例皮瓣下积液,均经过换药引流处理后愈合。其余患者皮瓣均完全成活,伤口一期愈合。术后均获7~29个月随访,皮瓣远期外观及功能恢复可,患者对手术效果满意。结论应用V-Y推进式背阔肌肌皮瓣修复胸壁缺损安全可靠,在修复较大面积胸壁创面的同时能够一期关闭供区创面,可获得较好的外观和功能。Objective To review clinical outcomes of extended V-Y latissimus dorsi myocutaneous flap in reconstruction of chest wall defects.Methods Patients receiving chest wall defect reconstruction with extended V-Y latissimus dorsi myocutaneous flap at Fudan University Zhongshan Hospital from January 2016 to December 2018 were enrolled.Patients were followed up for more than 6 months to detect complications such as blood supply disorder of the flap,wound dehiscence,seroma or tumor recurrence.Results A total of 16 patients,aged 28-78 years,with an average age of 54.8 years,were included.The chest wall defect size ranged from 10 cm×15 cm to 19 cm×26 cm.Among these cases,1 case had venous congestion in the distal triangle area of the flap,1 case had partial wound dehiscence of the flap,2 cases developed seroma on the back and 2 cases under the flap.All cases healed after changing dressing and drain placement.All the other cases had complete flap survival and primary wound healing.All cases were followed up from 7 to 29 months,with good flap appearance and function and patient satisfaction with results.Conclusions Chest wall defect reconstruction with V-Y latissimus dorsi myocutaneous flap is safe and reliable.It can repair a large chest wall wound and allow primary closure of the donor site simultaneously,which is worthy of being popularized in chest wall reconstruction.

关 键 词：外科皮瓣 背阔肌肌皮瓣 胸壁缺损 修复重建 

分 类 号：R641[医药卫生—外科学]