摘要
目的探究扩张后胸三角皮瓣治疗修复因烧烫伤所致的颈部带状瘢痕挛缩畸形的效果。方法回顾性分析2013年7月~2015年7月治疗的52例因烧烫伤所致的颈部带状瘢痕挛缩畸形患者,其中男性30例,女性22例;年龄12~45岁,平均（22.24±9.38）岁。所有患者采用扩张器行单侧或双侧胸三角皮瓣预扩张,2个月后切除颈部瘢痕,胸三角皮瓣覆盖;1个月后断蒂,利用蒂部皮瓣修复剩余瘢痕切除松解后的创面。结果扩张器破裂1例,创面感染2例,局部血肿1例,上述情况经处理治疗均未影响到后期手术的开展。术后1例发生逆行皮瓣静脉回流障碍;术后14d,3例皮瓣远端部分表皮坏死,并伴轻度增生性瘢痕形成,经处理后均恢复良好,所有患者皮瓣均顺利成活。术后随访1年,所有患者颈部瘢痕松解,颈部活动范围及功能恢复正常,无再次挛缩发生。结论扩张后胸三角皮瓣治疗可有效修复颈部带状瘢痕挛缩畸形,解除功能活动障碍,值得临床推广与应用。
Objective To investigate the effect of expanded dehopectoral skin flap for repairing cervical scar contracture deformity. Methods The retrospective study was carried out on 52 patients with cervical scar contraeture deformity who were admitted into our hospital from Jul. 2013 to Jul. 2014. Among them 30 were males and 22 were females;the mean age was （22. 24 ±9. 38） years（ 12-45） years. The expanders were inserted into the subcutaneous pockets in the dehopectoral zone and were inflated by expansion model. Two months later, the cervical scar was resected and covered with deltopectoral skin flap. The wound was repaired by the expansion flap and the skin flap pedicle was divided after one month. Results Expander rupture occurred in 1 case;wound infection oc- curred in 2 cases and local hematoma occurred in 1 case. All the problems were handled suecesefully without affecting later operations. One case developed venous flow obstruction in the reverse flap. Distal flap partial epidermal necrosis with mild hypertrophic scar formation developed in 3 cases 14 d after operations. All the above problems were handled succesefully. All flaps survived. Post-operative follow-up of one year revealed that the cervieo-man- dibular function and the external appearance of all the flaps were satisfactory without swelling and contracture. Conclusion The expanded deltopectoral flap is capable of effectively repairing the cervical scar contracture deformity and recovering normal functions. It is worthy of clinical popularization and application.
出处
《创伤外科杂志》
2016年第5期295-297,共3页
Journal of Traumatic Surgery
关键词
烧烫伤
颈部瘢痕
挛缩畸形
皮瓣
修复
bnrn injury
cervical scar
contracture deformity
flap
repair
