CAJ | 학술논문

目的修复头皮恶性肿瘤切除后的复杂创面,尤其是伴有部分颅骨缺损,甚至部分硬脑膜缺损的创而.方法应用游离背阔肌肌皮瓣,修复17例头皮恶性肿瘤切除后的创而(>200 cm2).结果 17例皮瓣全部存活,1例皮瓣下局部感染,经换药后愈合.9例术后4周开始放疗.17例均未要求颅骨修补.随访6-25个月,4例肿瘤复发,其中3例死亡;1例肺转移;12例无瘤生存.结论游离背阔肌肌皮瓣是修复头皮恶性肿痛切除后复杂创面的理想选择之一.
목적 수복두피악성종류절제후적복잡창면,우기시반유부분로골결손,심지부분경뇌막결손적창이.방법 응용유리배활기기피판,수복17례두피악성종류절제후적창이(>200 cm2).결과 17례피판전부존활,1례피판하국부감염,경환약후유합.9례술후4주개시방료.17례균미요구로골수보.수방6-25개월,4례종류복발,기중3례사망;1례폐전이;12례무류생존.결론 유리배활기기피판시수복두피악성종통절제후복잡창면적이상선택지일.
Objective To deal with complicated defect 'after ablation of scalp malignant tumor, especially in patients with cranium or dura defect. Method Seventeen consecutive scalp reconstructions with free latissimus dorsi musculocutaneous flap after large tumors ablation were reviewed. Results The scalp defects varied from 15 cm × 15 cm to 20 cm ×25 cm. The cranium defect varied from 5 cm ×5 em to 14 cm× 14 cm. There were seven patients with dura defect. The dura defects varied from 5 cm ×5 cm to 10 cm ×9 cm. The areas of latissimus dorsi musculocutaneous flap varied from 19 cm × 20 cm to 30 cm× 25cm. All flaps survived intact. The defects healed primarily expect one infection under the flap. There were nine patients undergone adjacent radiotherapy. No cranioplasty was needed. Follow up time was from six months to twenty-five months (mean 17 months). There were four local recurrences and one metastasis on lung. Twelve patients survived without tumor. Conchusions The latissimus dorsi musculocutaneous flap is an optimal choice for reconstruction of extensive defect after tumor ablation.