CAJ | 학술논문

目的探讨上臂内侧扩张皮瓣的血供及用于治疗颈部不同程度的瘢痕挛缩的方法.方法对10例患者分期手术:Ⅰ期手术时将扩张器置入上臂内侧深筋膜浅层;Ⅱ期手术时,利用尺侧上副动脉或尺侧返动脉供血、贵要静脉属支及腋静脉属支回流的上臂内侧扩张皮瓣带蒂转移修复松解颈部瘢痕挛缩后的创面;Ⅲ期时将扩张皮瓣断蒂,扩张皮瓣最大面积25 cm×15 cm.结果移植皮瓣全部成活,皮瓣色泽及性状接近颈部正常组织,外形良好,上臂内侧供瓣区遗留较小的继发畸形.结论将扩张器置于上臂内侧皮肤深筋膜浅层形成的扩张皮瓣用于治疗颈部瘢痕挛缩,是一个可行的方法,但分期治疗需要较长时间,在转移期间上肢与头部问的强迫体位固定的痛苦是其不足.
목적 탐토상비내측확장피판적혈공급용우치료경부불동정도적반흔련축적방법.방법 대10례환자분기수술:Ⅰ기수술시장확장기치입상비내측심근막천층;Ⅱ기수술시,이용척측상부동맥혹척측반동맥공혈、귀요정맥속지급액정맥속지회류적상비내측확장피판대체전이수복송해경부반흔련축후적창면;Ⅲ기시장확장피판단체,확장피판최대면적25 cm×15 cm.결과 이식피판전부성활,피판색택급성상접근경부정상조직,외형량호,상비내측공판구유류교소적계발기형.결론 장확장기치우상비내측피부심근막천층형성적확장피판용우치료경부반흔련축,시일개가행적방법,단분기치료수요교장시간,재전이기간상지여두부문적강박체위고정적통고시기불족.
Objective To investigate the blood supply of the expanded skin flap from medial up-per arm and its application in the reparation of cervical scar contracture due to sear resection. Methods The operation was carried out for three steps: (1) The expander was implanted under the superficial fascia. (2) The skin flap from medial upper arm was created with superior ulnar collateral artery as blood supply and attributive branches of basilica and axillary veins as blood collection. (3) After thes car contracture was released, the defect was covered with medial upper arm flap with maximal area of 25 cm×15 cm. Results Ten patients in all with cervical scar contracture were treated with the skin flap. All the skin flaps survived at last with nearly normal skin color, texture and contour. And the scar in donor sites seemed to be neglectable. Conclusions Reparation of cervical scar contracture with medial upper arm skin flap after expanding could be recommended. But 3 months long time and fixation of upper limb and head might be disadvantages.