带蒂轴型皮瓣用于修复头皮恶性肿瘤切除后继发创面的临床疗效观察  

The observation of the clinical curative effect of skin flap with tiled shaft in repairing secondary wound after the resection of malignant tumor of scalp

作　　者：卢颖洁[1] 吴敏[2] 涂峻 廖怀伟[1] 肖乐强 文辉才[1] 黄进军 付建华[1] LU Ying-jie;WU Min;TU Jun;LIAO Huai-wei;XIAO Le-qiang;WEN Hui-cai;HUANG Jin-jun;FU Jian-hua(First Affiliated Hospital Of Nanchang University,Jiangxi Province,330006,China;Jiangxi Children's Hospital Orthopedic Department,Jiangxi Province,330006,China)

机构地区：[1]南昌大学第一附属医院整形美容科,江西南昌330006 [2]江西省儿童医院骨科,江西南昌330006

出　　处：《中国医疗美容》2022年第9期23-25,共3页China Medical Cosmetology

摘　　要：目的探讨带蒂轴型皮瓣在头皮恶性肿瘤切除后继发创面修复中的临床应用及疗效。方法2012年1月~2020年12月,对45例头皮恶性肿瘤患者行肿瘤根治性切除后形成的创面,采用以颞浅动脉或枕动脉为主要供血血管的带蒂轴型皮瓣进行修复,供瓣区采用全厚或中厚游离皮片进行移植修复。结果所有患者恶性肿瘤切缘、基底均切除干净,1例皮瓣远端部分坏死;4例出现静脉回流障碍,经高压氧治疗后皮瓣血运得到改善并最终存活;3例皮片部分坏死,经过换药后二期愈合。其余皮瓣及皮片均成活良好,供区均一期愈合。术后随访6~60个月,平均17个月。1例复发,余未见肿瘤复发。结论带蒂轴型皮瓣是修复头皮恶性肿瘤切除后继发创面的有效方法,值得推广。Objective To study the clinical application and curative effect of skin flap with tiled shaft in the repairation of secondary wound after the resection of malignant tumor of scalp.Method In October 2011 to May 2017,45 cases of scalp malignant tumor were treated by radical resection of the wounds.We used Skin flap with tiled shaft which was superficial temporal artery or pillow artery as the main blood vessel to repair the wounds.The donor site was repaired with full thickness or medium thickness free skin graft.Results All the cutting edge of malignant tumor and base excision were removed,1 of these distal skin flap necrosis.Four cases had venous reflux obstruction,and the blood supply of the flap was improved and finally survived after hyperbaric oxygen treatment.3 of these partial necrosis of free skin,they were healing by second intention after the change of medicine,the other skin and skin flap were survived well,all the donor sites were primary healing.Postoperative follow-up period was 6 months to 5 years,suffer relapse only 1 patient,No tumor recurrence of the rest was observed.Conclusion The Skin flap with tiled shaft is an effective method to repair the secondary wound after the scalp malignant tumor excision,and it is worth popularizing.

关 键 词：带蒂轴型皮瓣 头皮恶性肿瘤 创面修复 

分 类 号：R739.5[医药卫生—肿瘤]