CAJ | 학술논문

背景：随着显微外科技术的发展与推广，游离皮瓣移植在临床应用越来越广泛，皮瓣游离移植能够解决局部组织量不足的问题。 　　目的：观察背阔肌肌皮瓣(肌瓣)游离移植对临床中出现的各类体表缺损的修复，以及重建组织完整及功能需要的作用。 　　方法：选取2010至2013年各类体表缺损病例18例，运用显微外科技术，采取背阔肌肌皮瓣(肌瓣)游离移植修复复杂创面。根据缺损原因，对原发创面进行处理，分离受区动静脉血管。皮瓣大多选择来自缺损同侧的背阔肌肌皮瓣(肌瓣)，根据缺损创面大小设计所需切取范围。如切取肌皮瓣(肌瓣)范围较大，继发创面难以直接缝合，可行游离皮片移植覆盖残余继发创面。 　　结果与结论：移植肌皮瓣(肌瓣)均成活，术后血运正常，功能恢复良好，外观经过整形技术能让患者自觉较为满意。背阔肌肌皮瓣(肌瓣)由于它供瓣区面积大，且部位较为隐蔽，显微外科技术，提高了游离移植的背阔肌肌皮瓣(肌瓣)的成活率，对于复杂创面的修复具有很大的优势。
배경：수착현미외과기술적발전여추엄，유리피판이식재림상응용월래월엄범，피판유리이식능구해결국부조직량불족적문제。 　　목적：관찰배활기기피판(기판)유리이식대림상중출현적각류체표결손적수복，이급중건조직완정급공능수요적작용。 　　방법：선취2010지2013년각류체표결손병례18례，운용현미외과기술，채취배활기기피판(기판)유리이식수복복잡창면。근거결손원인，대원발창면진행처리，분리수구동정맥혈관。피판대다선택래자결손동측적배활기기피판(기판)，근거결손창면대소설계소수절취범위。여절취기피판(기판)범위교대，계발창면난이직접봉합，가행유리피편이식복개잔여계발창면。 　　결과여결론：이식기피판(기판)균성활，술후혈운정상，공능회복량호，외관경과정형기술능양환자자각교위만의。배활기기피판(기판)유우타공판구면적대，차부위교위은폐，현미외과기술，제고료유리이식적배활기기피판(기판)적성활솔，대우복잡창면적수복구유흔대적우세。
BACKGROUND:With the development of microsurgical techniques, free flap transplantation has been widely used, which can solve the problem of insufficient local tissues. OBJECTIVE:To observe the clinical effects of latissimus dorsi free flap transfer on the repair of al kinds of body surface defects, as wel as the role in complete tissue and functional reconstruction. METHODS:From 2010 to 2013, 18 cases of various types of body surface defects were selected and using the microsurgical techniques, these complex wounds were repaired with free latissimus dorsi myocutaneous flaps. According to defect reason, primary wounds were treated for arteriovenous separation in the recipient zone. Most of the flaps were latissimus dorsi myocutaneous flaps at the affected side which were cut according to the wound size. If the cut muscle flap had a larger size and secondary wounds were difficult to be directly sutured, free skin grafts could be used to cover the residual secondary wounds. RESULTS AND CONCLUSION:After transplantation, al the flaps survived with normal blood supply and wel-recovered function. Patients were more satisfied with the flap appearance. Latissimus dorsi myocutaneous flaps characterized as large donor area and secluded location have a great advantage in the repair of complex wounds using microsurgical techniques that can improve the survival rate of latissimus dorsi myocutaneous flaps.