CAJ | 학술논문

目的探讨以颈前部为蒂的双翼状薄型扩张皮瓣的设计方式及其在修复大面积面中下部瘢痕中的应用. 方法 2000年2月-2013年7月,笔者单位应用颈前部蒂双翼状薄型扩张皮瓣治疗26例面中下部瘢痕患者.于颈部放置扩张器扩张后,切取163～ 275 cm2大小颈前部蒂双翼状薄型扩张皮瓣,按皮瓣可覆盖的范围切除并松解面中下部瘢痕(面积为135～ 196 cm2),将皮瓣通过旋转及推进转移至面中下部,逐层缝合切口. 结果本组26例患者术后随访2 ～ 24个月,21例皮瓣转移后存活良好,整体外观和功能恢复均较佳.4例皮瓣远端出现静脉回流障碍,1例皮瓣出现右侧翼缺血坏死,经游离植皮后痊愈. 结论颈前部为蒂的双翼状扩张皮瓣既可以在保证皮瓣血运的同时充分利用扩张皮瓣,亦保证了术后颈部及面部良好的色泽、质地及外形轮廓.
목적 탐토이경전부위체적쌍익상박형확장피판적설계방식급기재수복대면적면중하부반흔중적응용. 방법 2000년2월-2013년7월,필자단위응용경전부체쌍익상박형확장피판치료26례면중하부반흔환자.우경부방치확장기확장후,절취163～ 275 cm2대소경전부체쌍익상박형확장피판,안피판가복개적범위절제병송해면중하부반흔(면적위135～ 196 cm2),장피판통과선전급추진전이지면중하부,축층봉합절구. 결과 본조26례환자술후수방2 ～ 24개월,21례피판전이후존활량호,정체외관화공능회복균교가.4례피판원단출현정맥회류장애,1례피판출현우측익결혈배사,경유리식피후전유. 결론 경전부위체적쌍익상확장피판기가이재보증피판혈운적동시충분이용확장피판,역보증료술후경부급면부량호적색택、질지급외형륜곽.
Objective To explore the application of alar thin expanded cervical flap with pedicle in anterior neck for large scars on middle and lower face.Methods From February 2000 to July 2013,26 patients with scars on the middle and lower face were treated with the alar thin expanded cervical flaps with pedicle in anterior neck.After the skin of anterior neck was expanded by implanting skin expanders,alar thin expanded cervical flap with pedicle in anterior neck was obtained with size of 163-275 cm2.Then the scars on the middle and lower face with the size of 135-196 cm2 were excised,with the area of excision allowing full coverage of the expanded flap.The flap was rotated and advanced to the middle and lower face,and the incision was closed in layers.Results The 26 patients were followed up for 2 to 24 months.Twentyone flaps survived,with good appearance and function.Four flaps showed venous retardation at distal part,and only one flap showed necrosis of the right edge.They were healed by free skin grafting.Conclusions The alar thin expanded cervical flap not only makes maximum use of expanded flap on the premise of ensuring blood supply,but also guarantees good color,texture,and contour of face and neck.