游离巨大背阔肌肌皮瓣联合自体皮移植在颅面部电损伤创面修复中的应用  

Application of free latissimus dorsi myocutaneous flap combined with autologous skin grafting in the repair of head electrical injury wounds

作　　者：杨成兰 袁凌 闫雪萍 曾雪琴 魏在荣 Yang Chenglan;Yuan Ling;Yan Xuepin;Zeng Xueqin;Wei Zairong(Department of Burns and Plastic Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University,Zunyi Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院烧伤整形外科,贵州遵义563000 [2]遵义医科大学组织损伤修复与再生医学省部共建协同创新中心,贵州遵义563000

出　　处：《遵义医科大学学报》2025年第3期263-269,共7页Journal of Zunyi Medical University

基　　金：贵州茅台医院科研与人才培养资金(NO:mtyk2022-13)。

摘　　要：目的 探讨利用游离巨大背阔肌肌皮瓣联合自体皮片拉网移植在高压电损伤所致颅面部创面修复中的临床应用效果。方法 2021年12月至2024年2月遵义医科大学附属医院烧伤整形科收治的15例高压电烧伤所致的颅面部复杂创面患者。其中男性11例,女性4例,年龄28~70岁,创面面积20.0 cm×11.0 cm~25.0 cm×13.0 cm,肌瓣切取面积22.0 cm×13.0 cm~28.0 cm×16.0 cm,皮瓣面积在10.0 cm×5.0 cm~18.0 cm×6.0 cm。对15例电烧伤所致的头部大面积软组织缺损患者,采用游离巨大背阔肌肌皮瓣联合自体拉网植皮进行修复。结果 本组患者术后皮瓣均完全成活,无皮瓣血管危象。1例患者出现皮下渗液,细菌培养阴性,经门诊换药1月后,创面愈合无渗液。所有患者供区愈合良好,随访6~24个月,无皮瓣下渗液,皮瓣无臃肿,外观满意。结论 游离巨大背阔肌肌皮瓣联合自体拉网植皮修复电击伤所致的颅面部大面积皮肤缺损安全有效,外观满意。Objective To explore the clinical efficacy of using a free large latissimus dorsi myocutaneous flap combined with meshed autologous skin grafting for the repair of craniofacial wounds caused by high-voltage electrical burns.Methods From December 2021 to February 2024,15 patients with complex craniofacial wounds caused by high-voltage electrical burns were treated in the Burn and Plastic Surgery Department of Zunyi Medical University Affiliated Hospital.The cohort included 11 males and 4 females,aged 28 to 70 years,with wound areas ranging from 20.0 cm×11.0 cm to 25.0 cm×13.0 cm,and myocutaneous flap harvesting areas ranging from 22.0 cm×13.0 cm to 28.0 cm×16.0 cm.For the large soft tissue defects in the heads of these 15 patients,the wounds were repaired using a free large latissimus dorsi myocutaneous flap combined with meshed autologous skin grafting.Results All patients in this group had complete survival of the skin flap postoperatively,with no vascular crises in the flaps.One patient experienced subcutaneous exudate,but bacterial culture was negative,and the wound healed without exudate after one month of outpatient dressing changes.All donor sites healed well.Follow-ups ranged from 6 to 24 months,with no sub-flap exudate,no flap swelling,and satisfactory cosmetic results.Conclusion The free latissimus dorsi myocutaneous flap combined with meshed autologous skin grafting is a safe and effective surgical method for repairing large craniofacial skin defects caused by electrical burns,providing satisfactory cosmetic outcomes.

关 键 词：背阔肌肌皮瓣 电损伤 颅面部 创面修复 

分 类 号：R622.1[医药卫生—整形外科]