CAJ | 학술논문

目的探讨颈部瘢痕挛缩的治疗方法.方法结合颈横动脉颈段皮支皮瓣的应用解剖,设计上界不超过锁骨的颈横动脉颈段皮支皮瓣的预扩张区域,将扩张器置入深筋膜下层进行预扩张.预扩张完成后,将颈部瘢痕全部或部分切除、松解挛缩,在扩张后皮瓣上,根据创面大小结合颈横动脉颈段皮支的应用解剖设计皮瓣.皮瓣剥离、旋转后无张力覆盖创面.供区拉拢缝合.结果本组17例,均为扩张后岛状皮瓣转移,扩张后皮瓣与颈部周围组织色泽、质地匹配良好,术后随访6 ～12个月,颈部瘢痕挛缩纠正彻底,效果满意.结论扩张后颈横动脉颈段皮支皮瓣,血供恒定,解剖容易,是修复严重的颈部瘢痕挛缩的良好选择.
목적 탐토경부반흔련축적치료방법.방법 결합경횡동맥경단피지피판적응용해부,설계상계불초과쇄골적경횡동맥경단피지피판적예확장구역,장확장기치입심근막하층진행예확장.예확장완성후,장경부반흔전부혹부분절제、송해련축,재확장후피판상,근거창면대소결합경횡동맥경단피지적응용해부설계피판.피판박리、선전후무장력복개창면.공구랍롱봉합.결과 본조17례,균위확장후도상피판전이,확장후피판여경부주위조직색택、질지필배량호,술후수방6 ～12개월,경부반흔련축규정철저,효과만의.결론 확장후경횡동맥경단피지피판,혈공항정,해부용역,시수복엄중적경부반흔련축적량호선택.
Objective To investigate the clinical application of expanded flap based on cutaneous branch of transverse cervical artery for reconstruction of cervical cicatricial contracture.Methods Based on the clinical anatomy of cutaneous branch of transverse cervical artery flap,we design the corresponding subclavicular area for expansion.The incision was usually located at the anterior axillary fold,5-8 cm in length.The expander was implanted under the deep fascial layer,without injury of the vascular pedicle.Fixation sutures were put about 1 cm apart from the incision to prevent the expander from transposition and exposure.After expansion,the cervical cicatricial contracture was excised and released.According to the defect,the expanded flap based on the cutaneous branch of transverse cervical artery was designed,with the pedicle located at the posterior margin of sternocleidomastoid and 1.8 cm above median point of clavicle."S" shape incision was made at the location of vascular pedicle.Subcutaneous dissection was performed 1.5 cm in width along the incision on both sides.Then the flap was harvested under the deep fascial layer and rotated to cover defect without tension.It was not necessary to dissect the vascular pedicle further.The defect at donor site was closed directly.Results 17 cases were treated with the island flap.The contracture of the cervical scar was corrected completely with aesthetic appearance.Conclusions Expanded flap based on cutaneous branch of transverse cervical artery has reliable blood supply.It' s an ideal flap for the treatment of cervical cicatricial contracture.