摘要
目的探讨一种保留胸大肌功能的改良胸大肌肌皮瓣的制作方法。方法根据胸大肌肌皮瓣的解剖学特点设计皮岛，将胸大肌肌皮瓣的血管蒂完全解剖出来而不携带肌肉，使肌皮瓣成为名副其实的岛状瓣，从而完整保留了胸大肌的锁骨部分以及胸大肌外侧大部分肌纤维。结果2002至2005年采用该方法制做改良胸大肌肌皮瓣29例，其中20例修复口内缺损，4例修复颈部缺损。3例修复腮腺区缺损，2例修复下咽部缺损。术后皮瓣全部成活，随访6个月至2年，所有患者术后进食、吞咽功能良好，语言功能大多恢复良好。结论改良胸大肌肌皮瓣应用于头颈外科克服了传统的胸大肌肌皮瓣的缺点，提高了肌皮瓣血供的可靠性，最大程度地保留了胸大肌的功能和胸部的外形。
Objective To analyze a producing method for modified pectoralis major myocutaneous （PMM） flap, with maintaining the function of pectoralis major muscle. Methods The skin island was designed according to the anatomical features of pectoralis major myocutaneous flap. The pedicle of PMM flap did not contain any muscle, making PMM flap into an accurate island flap. The clavicle of pectoralis major muscle as well as most of lateral part fiber was well maintained. Results From 2002 to 2005, 29 PMM flaps were performed by this modified method, 20 flaps used to reconstruct defect of oral, 4 flaps to reconstruct defect of neck,3 flaps to reconstruct defect of parotid gland and 2 flaps to reconstruct laryngopharynx. All flaps were survival postoperation. The speaking and swallowing functions were satisfactory after 6 months- 2 years＇ followups. Conclusion The application of modified pectoralis major myocutaneous flap overcomes the disadvantage of outdated method, improving the feasibility and availability of blood supply of muscle flap. Besides, it almost maintains the function of pectoralis major muscle and the appearance features of chest. Thus, this modified technique turns this flap more reliable and versatile in head and neck.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2007年第3期193-195,共3页
Chinese Journal of Plastic Surgery
关键词
胸大肌肌皮瓣
修复
Pectoralis major myocutaneous flap
Reconstruction
