CAJ | 학술논문

目的：探讨慢性胸部放射性溃疡缺损的修复方法。方法自2010年4月至2013年6月，对10例胸部慢性溃疡患者实行分期治疗。Ⅰ期清创，大网膜填塞；Ⅱ期行皮瓣转移修复创面，包括背阔肌带蒂移植及胸大肌肌皮瓣转移。术后观察手术疗效及并发症情况。结果术后随访26~37个月，平均随访25个月。所有患者无手术死亡，转移皮瓣无一例发生坏死。1例患者术后出现皮下积液，经抽液后加压包扎痊愈。其余患者无术后感染情况发生。患者术后呼吸功能良好，无反常呼吸运动。结论对于慢性溃疡的修复，分期治疗可取得较好的临床治疗效果。大网膜瓣适用于软组织缺损的充填，尤其是感染性软组织缺损。
목적：탐토만성흉부방사성궤양결손적수복방법。방법자2010년4월지2013년6월，대10례흉부만성궤양환자실행분기치료。Ⅰ기청창，대망막전새；Ⅱ기행피판전이수복창면，포괄배활기대체이식급흉대기기피판전이。술후관찰수술료효급병발증정황。결과술후수방26~37개월，평균수방25개월。소유환자무수술사망，전이피판무일례발생배사。1례환자술후출현피하적액，경추액후가압포찰전유。기여환자무술후감염정황발생。환자술후호흡공능량호，무반상호흡운동。결론대우만성궤양적수복，분기치료가취득교호적림상치료효과。대망막판괄용우연조직결손적충전，우기시감염성연조직결손。
Objective To explore the surgical reconstruction of chronic radiation-induced ulcer in chest wall by stages. Methods From April 2010 to June 2013, 10 patients with huge chronic chest wall defect underwent chest wall reconstruction by stages. In stage Ⅰ, patients received debridement and greater omentum tamping; In stage Ⅱ, patients received surgical reconstruction by regional rotation flap, including pedicle latissimus dorsi myocutaneous flap and pectoralis major myocutaneous flap. The clinical efficacy and postoperative complications were observed. Results All the patients were followed up for 26-37 months (mean 25 months). There were no operating death and local failure. One patient were suffered from subcutaneous infection which healed by debridement and drainage. No infection were observed in other patients. No paradoxical respiration occurred in all patients. Conclusion Stage therapeutics is effective in treating chronic radiation-induced ulcer and defect. Great omentum flap is useful for the repair of soft tissue defect, which is priority for defects caused by infection.