CAJ | 학술논문

目的探讨颈浅动脉皮瓣修复上肢撕脱离断再植术中及术后肩关节周围创面的临床治疗效果.方法自2003年3月至2010年5月,利用颈横动脉发出的分布于斜方肌及肩胛背部位的颈浅动脉,设计颈浅动脉皮瓣,临床应用7例,包括急诊修复上臂离断合并皮肤软组织缺损1例,二期修复再植术后出现的肩关节周围继发创面6例.皮瓣面积为15 cm×8 cm～ 35 cm×20 cm,血管蒂长约5～6 cm.结果其中1例皮瓣术后伤口感染,远端开裂约2 cm,创面经换药后愈合;其余6例皮瓣全部存活,无血管危象发生.术后随访时间为6～84个月,皮瓣质地、弹性、外形均满意.结论该皮瓣面积较大,可容易地转移达到覆盖肩关节创面的目的,并且不损伤背阔肌、胸大肌蒂部血管以及背阔肌肌皮瓣、胸大肌皮瓣供区部位皮肤,为上肢再植术后二期修复与功能重建提供足够、充分的肌肉和皮肤.
목적 탐토경천동맥피판수복상지시탈리단재식술중급술후견관절주위창면적림상치료효과.방법 자2003년3월지2010년5월,이용경횡동맥발출적분포우사방기급견갑배부위적경천동맥,설계경천동맥피판,림상응용7례,포괄급진수복상비리단합병피부연조직결손1례,이기수복재식술후출현적견관절주위계발창면6례.피판면적위15 cm×8 cm～ 35 cm×20 cm,혈관체장약5～6 cm.결과 기중1례피판술후상구감염,원단개렬약2 cm,창면경환약후유합;기여6례피판전부존활,무혈관위상발생.술후수방시간위6～84개월,피판질지、탄성、외형균만의.결론 해피판면적교대,가용역지전이체도복개견관절창면적목적,병차불손상배활기、흉대기체부혈관이급배활기기피판、흉대기피판공구부위피부,위상지재식술후이기수복여공능중건제공족구、충분적기육화피부.
Objective To explore the application of superficial carotid artery flap in the intraoperative or postoperative management of shoulder wounds in replantation of amputated upper arm and its clinical outcomes.Methods From March 2003 to May 2010, a flap was designed based on the superficial carotid artery branching off the transverse cervical artery through the trapezius muscle and the dorsal scapular region.This flap was used in 7 cases including emergent repair of soft tissue defect in upper arm replantation in one case and secondary coverage of shoulder wound following replantation in 6 cases.The size of the flaps ranged from 15 cm × 8 cm to 35 cm × 20 cm.The length of the vascular pedicle was about 5 to 6 cm.Results Postoperatively, infection of the flap occurred in one case with 2 cm distal wound dehiscence that was healed with wound care.Uneventful survival of all other 6 flaps was observed.There was no vascular crisis.Postoperative follow-up period ranged from 6 to 84 months.The texture and appearance of the flaps were satisfactory.Conclusion Superficial carotid artery flap can be large in size and readily transferred to reach and cover defects of the shoulder region.Many with amputated upper ann skin avulsion, intraoperative and postoperative flap wound required.Larger area of the scope of the flap can be transferred more easily to achieve the purpose of wound coverage.Secondly, the late function after replantation of severed poor, often line features two required reconstructive surgery.Flap harvesting does not damage neither vessels to the latissimus dorsi and pectoralis major muscles nor the overlying skin.This spares these important myocutaneous flaps for secondary functional transfers.