中国美容医学
中國美容醫學
중국미용의학
CHINESE JOURNAL OF AESTHETIC MEDICINE
2015年
12期
1-4
,共4页
田佳%范金财%白永强%刘立强%甘承%杨增杰%焦虎%陈文霖%殷竹鸣%韩兵%薛兵建
田佳%範金財%白永彊%劉立彊%甘承%楊增傑%焦虎%陳文霖%慇竹鳴%韓兵%薛兵建
전가%범금재%백영강%류립강%감승%양증걸%초호%진문림%은죽명%한병%설병건
胸部瘢痕%超量扩张%背阔肌肌皮瓣
胸部瘢痕%超量擴張%揹闊肌肌皮瓣
흉부반흔%초량확장%배활기기피판
chest scar%excessive expansion%latissimus dorsi myocutaneous flap
目的：介绍利用超量扩张的背阔肌肌皮瓣修复女性胸部正中大面积挛缩瘢痕的手术方法，探讨其在应用方面的优势，为临床推广应用提供参考。方法：2009年-2014年，笔者使用本方法对16例烧伤后胸部正中大面积瘢痕的女性患者进行修复。使用800ml长方形扩张器扩张单侧背阔肌肌皮瓣，超量扩张2.5倍以上。扩张完成后，取出扩张器，以皮下隧道方式将扩张肌皮瓣转移至胸部，修复胸部正中瘢痕。供区一期缝合。结果：全部皮瓣均成活良好.平均皮瓣面积为28cm×22cm。扩张器扩张及手术过程中出现个别并发症，经积极处理，未对最终手术结果照成影响。术后患者功能外观改善明显，皮瓣颜色质地良好，回缩率低，效果稳定。供区均一期愈合，未见明显背部畸形或肩关节活动障碍。结论：单侧超量扩张的背阔肌肌皮瓣修复女性胸部正中大面积瘢痕临床效果好，组织量充足，供区隐蔽，是较为理想的修复方法。皮瓣血运稳定，手术操作相对简单，易于推广。
目的：介紹利用超量擴張的揹闊肌肌皮瓣脩複女性胸部正中大麵積攣縮瘢痕的手術方法，探討其在應用方麵的優勢，為臨床推廣應用提供參攷。方法：2009年-2014年，筆者使用本方法對16例燒傷後胸部正中大麵積瘢痕的女性患者進行脩複。使用800ml長方形擴張器擴張單側揹闊肌肌皮瓣，超量擴張2.5倍以上。擴張完成後，取齣擴張器，以皮下隧道方式將擴張肌皮瓣轉移至胸部，脩複胸部正中瘢痕。供區一期縫閤。結果：全部皮瓣均成活良好.平均皮瓣麵積為28cm×22cm。擴張器擴張及手術過程中齣現箇彆併髮癥，經積極處理，未對最終手術結果照成影響。術後患者功能外觀改善明顯，皮瓣顏色質地良好，迴縮率低，效果穩定。供區均一期愈閤，未見明顯揹部畸形或肩關節活動障礙。結論：單側超量擴張的揹闊肌肌皮瓣脩複女性胸部正中大麵積瘢痕臨床效果好，組織量充足，供區隱蔽，是較為理想的脩複方法。皮瓣血運穩定，手術操作相對簡單，易于推廣。
목적：개소이용초량확장적배활기기피판수복녀성흉부정중대면적련축반흔적수술방법，탐토기재응용방면적우세，위림상추엄응용제공삼고。방법：2009년-2014년，필자사용본방법대16례소상후흉부정중대면적반흔적녀성환자진행수복。사용800ml장방형확장기확장단측배활기기피판，초량확장2.5배이상。확장완성후，취출확장기，이피하수도방식장확장기피판전이지흉부，수복흉부정중반흔。공구일기봉합。결과：전부피판균성활량호.평균피판면적위28cm×22cm。확장기확장급수술과정중출현개별병발증，경적겁처리，미대최종수술결과조성영향。술후환자공능외관개선명현，피판안색질지량호，회축솔저，효과은정。공구균일기유합，미견명현배부기형혹견관절활동장애。결론：단측초량확장적배활기기피판수복녀성흉부정중대면적반흔림상효과호，조직량충족，공구은폐，시교위이상적수복방법。피판혈운은정，수술조작상대간단，역우추엄。
Objective To introduce using unilateral excessive expanded latissimus dorsi myocutaneous flap for the repairment of large contracted scar in the central part of female chest. Evaluate this method and provide a reference for the clinical selection of appropriate treatment options. Methods From 2009 to 2014,16 female burn sequala patients underwent this two-staged operation for large contracted scar in the central part of chest reconstruction.A rectangle tissue expander (800ml) was inserted underneath unilateral latissimus dorsi in the first stage.After being expanded excessively over 2.5 times of the design capacity,the tissue expender was removed and the expanded myocutaneous flap was transferred to the central chest area via subcutaneous tunnel. The donor site was closed primarily. Results All flaps survived.The average size of the flaps was 28cm × 22cm.A few minor complications happened during the expanding and the post-operational period,which were controlled by positive treatments without affecting the final results.The appearance and function of the patients had improved significantly.The retraction rate of the flaps was low,the results were stable.The donor site healed without morbidity or obvious shoulder dysfunction. Conclusion Unilateral excessive expanded latissimus dorsi myocutaneous flap provides abundant tissue for large contracted scar repairment in the central part of female chest with donor site being well-concealed and preserved. This is a simple and safe method, which is worth recommended.
