CAJ | 학술논문

目的：探讨扩张的颈肩峰区锁骨上皮瓣修复面颈部较大面积软组织缺损的临床治疗效果。方法：2008年1月至2014年1月对24例面颈部软组织缺损患者，年龄5～42岁，采用以锁骨上动脉为蒂的预扩张的颈肩峰区筋膜皮瓣修复。一期在颈肩峰区域深筋膜浅层埋置1～2枚扩张器（600～800ml），定期注水，二期切除面颈部瘢痕或色素病变，以扩张皮瓣带蒂转移修复组织缺损，供区多可直接缝合。结果：本组24例患者扩张皮瓣切取面积为20cm×8cm～23cm×16cm，皮瓣均成活良好，无显著并发症。术后随访3～24个月，皮瓣颜色质地与面颈部受区皮肤接近，外观和功能恢复满意，皮瓣供区瘢痕增生不明显，无功能障碍。结论：以锁骨上动脉为蒂的颈肩峰扩张皮瓣是修复面颈部大面积软组织缺损的可靠方法，尤其在缺损周围正常皮肤组织量不足时，是理想的修复方式。
목적：탐토확장적경견봉구쇄골상피판수복면경부교대면적연조직결손적림상치료효과。방법：2008년1월지2014년1월대24례면경부연조직결손환자，년령5～42세，채용이쇄골상동맥위체적예확장적경견봉구근막피판수복。일기재경견봉구역심근막천층매치1～2매확장기（600～800ml），정기주수，이기절제면경부반흔혹색소병변，이확장피판대체전이수복조직결손，공구다가직접봉합。결과：본조24례환자확장피판절취면적위20cm×8cm～23cm×16cm，피판균성활량호，무현저병발증。술후수방3～24개월，피판안색질지여면경부수구피부접근，외관화공능회복만의，피판공구반흔증생불명현，무공능장애。결론：이쇄골상동맥위체적경견봉확장피판시수복면경부대면적연조직결손적가고방법，우기재결손주위정상피부조직량불족시，시이상적수복방식。
Objective To investigate the therapeutic effect of pre-expanded cervico-acromial flap based on the supraclavicular artery for resurfacing soft tissue defects of head and neck. Methods In this series,from Jan 2008 to Jan 2014,24 patients with ages between 5 and 42 years suffering from facial and cervical scar or nevis or port-wine stain were treated.In the first stage,the tissue expander (600ml to 800ml in volume) was implanted on the deep fascia layer of the cervicoacromial region;600 to 800ml saline were injected during a 10 to 16 weeks period.In the second stage after expansion, sufficient skin and tissue was obtained to resurface the defects of head and neck. Results All 24 flaps healed primarily with good functional and cosmetic results.The maximum size of the flap was 23cm × 16cm,whereas the minimum size was 20cm × 8cm.After an average follow-up time of 12 months, significant improvement in function with good esthetic outcomes were achieved,and the donor sites scar seemed acceptable.There were no significant complications. Conclusion The pre-expandedcervico-acromialfasciocutaneous flap based on the supraclavicularartery can provide a large amount of thin tissue with both good color and texture,and without the need for microsurgery, and avoid the disadvantages of donor-site morbidity.This flap is reliable and safe for resurfacing large skindefects of the head and neck.