中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2013年
3期
211-214
,共4页
唐举玉%卿黎明%梁捷予%宋达疆%俞芳%杜威%王聪杨
唐舉玉%卿黎明%樑捷予%宋達疆%俞芳%杜威%王聰楊
당거옥%경려명%량첩여%송체강%유방%두위%왕총양
背阔肌皮瓣%下肢%重建%显微外科
揹闊肌皮瓣%下肢%重建%顯微外科
배활기피판%하지%중건%현미외과
Latissimus doris flap%Lower extremety%Reconstruction%Microsurgery
目的 探讨应用改良背阔肌皮瓣移植修复下肢巨大面积皮肤软组织缺损的可行性及临床效果. 方法 根据背阔肌皮瓣特点,切取有限面积的皮瓣携带大面积的背阔肌肌瓣,植皮区域由供区转移到受区.2009年4月至2011年8月共收治下肢巨大面积皮肤软组织缺损患者10例,皮肤软组织缺损范围19 cm×10 cm～32 cm×16 cm,均采用改良背阔肌皮瓣移植修复,受区肌瓣表面植皮修复,供区创面直接缝合.切取的背阔肌皮瓣加肌瓣面积最大33 cm×17 cm,最小20 cm×11 cm,其中皮瓣部分面积为20cm×6cm～33 cm×10cm.结果 术后所有皮瓣和植皮均顺利存活,无相关并发症.供区均直接缝合,愈合良好.术后随访6～36个月,皮瓣质地良好,外形不臃肿,供区仅留线性瘢痕,外观影响小,肩关节活动无影响. 结论 改良背阔肌皮瓣可用于修复下肢巨大面积皮肤软组织缺损,不但减少了供区并发症,还可改善供、受区的外形,值得临床推广应用.
目的 探討應用改良揹闊肌皮瓣移植脩複下肢巨大麵積皮膚軟組織缺損的可行性及臨床效果. 方法 根據揹闊肌皮瓣特點,切取有限麵積的皮瓣攜帶大麵積的揹闊肌肌瓣,植皮區域由供區轉移到受區.2009年4月至2011年8月共收治下肢巨大麵積皮膚軟組織缺損患者10例,皮膚軟組織缺損範圍19 cm×10 cm～32 cm×16 cm,均採用改良揹闊肌皮瓣移植脩複,受區肌瓣錶麵植皮脩複,供區創麵直接縫閤.切取的揹闊肌皮瓣加肌瓣麵積最大33 cm×17 cm,最小20 cm×11 cm,其中皮瓣部分麵積為20cm×6cm～33 cm×10cm.結果 術後所有皮瓣和植皮均順利存活,無相關併髮癥.供區均直接縫閤,愈閤良好.術後隨訪6～36箇月,皮瓣質地良好,外形不臃腫,供區僅留線性瘢痕,外觀影響小,肩關節活動無影響. 結論 改良揹闊肌皮瓣可用于脩複下肢巨大麵積皮膚軟組織缺損,不但減少瞭供區併髮癥,還可改善供、受區的外形,值得臨床推廣應用.
목적 탐토응용개량배활기피판이식수복하지거대면적피부연조직결손적가행성급림상효과. 방법 근거배활기피판특점,절취유한면적적피판휴대대면적적배활기기판,식피구역유공구전이도수구.2009년4월지2011년8월공수치하지거대면적피부연조직결손환자10례,피부연조직결손범위19 cm×10 cm～32 cm×16 cm,균채용개량배활기피판이식수복,수구기판표면식피수복,공구창면직접봉합.절취적배활기피판가기판면적최대33 cm×17 cm,최소20 cm×11 cm,기중피판부분면적위20cm×6cm～33 cm×10cm.결과 술후소유피판화식피균순리존활,무상관병발증.공구균직접봉합,유합량호.술후수방6～36개월,피판질지량호,외형불옹종,공구부류선성반흔,외관영향소,견관절활동무영향. 결론 개량배활기피판가용우수복하지거대면적피부연조직결손,불단감소료공구병발증,환가개선공、수구적외형,치득림상추엄응용.
Objective To explore the feasibility and clinic outcome of the modified latissimus dorsi flap when it is used to repair huge soft tissue defects in lower limbs.Methods The latissimus dorsi muscle is rich blood supply and available for harvest huge areas.According to these characteristics the modified latissimus dorsi flap was designed:a limited latissimus dorsi skin flap with a large area of latissimus dorsi muscle flap,skin graft area was transferred from donor-site to recipient-site.From April 2009 to August 2011,ten patients with large soft tissue defects in lower limbs were treated with modified latissimus dorsi flap.The size of skin and soft tissue defects range from 19 cm × 10 cm to 32 cm × 16 cm.Ten modified latissimus dorsi flaps had been used for coverage of these wounds,which were amplified 1-2 cm compared with the corresponding wounds.The size of skin flap was 20 cm × 6 cm-33 cm × 10 cm which was allowable to get direct closure of donor-site wounds.Results All the flaps and skin graft survived completely with no complication.Donor-site and recipient-site were primary closed and healing in all patients.All of the patients had got follow-up from 6 months to 36 months.All flaps survived with excellent color and quality,and no extremely fat contour.The results in donor site were satisfying and only left liner scar.It has no effect in the shoulder function.Conclusion The modified latissimus doris flap can provide with a huge amount of skin and soft tissue and be designed in various ways.It is a safe and reliable way to reconstruct huge skin and soft tissue defect in lower limbs.
