埋线延时在颈横动脉颈段皮支扩张皮瓣修复面部创面中的应用  

Application of the suture embedding ligation delayed technique by ligaturing blood vessels in facial wound repair with ex-pansion skin flaps of the cervical cutaneous branch of transverse cervical artery

作　　者：刘飞 刘要伟 程彬 秦王驰 崔晔 杨卫国 林海波 郭正东 熊玮 王芳芳 梁智 LIU Fei;LIU Yaonei;CHENG Bin;QIN Wangchi;CUI Ye;YANG Weiguo;LIN Haibo;GUO Zhengdong;XIONG Wei;WANG Fang-fang;LIANG Zhi(Department of Plastic and Burn Surgery,Huazhong University of Science and Technology Union Shenzhen(Nan-shan)Hospital,Shenzhen 518052,China)

机构地区：[1]华中科技大学协和深圳医院(南山医院)整形美容烧伤科,广东深圳518052

出　　处：《中国美容整形外科杂志》2024年第7期421-424,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：深圳市南山区科技计划重点项目(NS2023006)。

摘　　要：目的 探讨埋线结扎颈横动脉颈段皮支扩张皮瓣周围血管的延时方法,提高皮瓣整体成活率。方法 回顾性分析自2012年5月至2021年12月,华中科技大学协和深圳医院(南山医院)整形美容烧伤科收治14例面部瘢痕、面部巨大色素痣、面部血管瘤、面部外伤患者,利用埋线延时技术对患者在皮瓣转位前进行治疗。一期根据面部创面情况,设计颈横动脉颈段皮支皮瓣大小及形状,选择相应扩张器并埋置,按计划注水扩张皮肤。皮瓣转位修复前4周,观察皮瓣供应血管,于扩张囊周边埋线结扎除颈横动脉皮支外可见的血管。结扎延时4周后,切除面部病灶,切取皮瓣转位修复创面,术后观察皮瓣成活情况并分析术后效果。结果 14例患者皮瓣转位后,全部成活,除1例远端边缘少许延迟愈合外,皮瓣整体成活率为100%,患者满意率为92.9%。结论 埋线结扎延时技术简单易操作、创伤较小,皮瓣整体成活率较高,患者满意度较高,值得在临床上推广应用。Objective To investigate the time-delay method of embedding and ligating of the vessels around the expanded skin flap with the cutaneous branch of the transverse carotid artery and improve the overall survival rate of the flap.Methods From March 2012 to December 2021,a total of 14 patients with facial scars,giant facial nevus,facial hemangioma,and facial trauma were treated in our hospital.In Phase I,according to the conditions of facial raw surface,the size and shape of the cutaneous branch flap of the transverse carotid artery were designed,the appropriate expander was selected and embedded,and the skin was expanded with water injection as planned.4 weeks before the transposition of the flap,the flaps were placed on the dilated flap with a flashlight to show the blood supply,and the flaps except the transverse carotid artery were ligated by embedding suture around the dilated sac to supply blood vessels.After the ligation delay of 4 weeks,the facial lesion was removed and the skin flap was removed and transpositioned to repair the wound.Results All 14 patients survived after flap transposition,except 1 case with slightly delayed healing at the distal edge,and none had necrosis.The overall survival rate of the flap was 100%,the patient satisfaction rate was 92.9%.Conclusion The suture embedding ligation delay technique is simple,easy to operate,less invasive,the overall survival rate of the expanded transverse carotid artery flap is high,and patient satisfaction is high,which is worthy of clinical application.

关 键 词：延时 颈横动脉 皮瓣 创面 

分 类 号：R622[医药卫生—整形外科]