【摘要】 目的探讨带蒂轴型背部肌皮瓣在邻近部位深度创面修复中的应用。方法 2005年至2010年中南大学湘雅医院烧伤整形外科采用轴型背部肌皮瓣转移修复邻近部位深度创面22例。烧(创)伤创面彻底清创、溃疡和肿瘤切除后采用胸背动脉为蒂的背阔肌肌皮瓣14例,背阔肌肌皮瓣联合髂腰皮瓣3例,联合胸大肌皮瓣1例,腰动脉和肋间后血管为蒂的逆行背阔肌肌皮瓣1例,下位斜方肌肌皮瓣3例。结果背阔肌肌皮瓣转移术后感染或远端部分坏死各1例;4例供瓣区植皮部分未成活,经再次扩创或二期植皮后愈合。其余组织瓣移植未见并发症发生。随访3～24月,修复部位功能和外观均基本满意。结论带蒂轴型背部肌皮瓣能满足颈、胸、上肢等深度创面覆盖的需要,可安全、有效地修复这些部位的深度创面。更多还原

【Abstract】 Objective To explore the application of pedicled axial myocutaneous flap from the posterior trunks repairing their adjacent deep wounds.Methods From 2005 to 2010,22 pedicled axial myocutaneous flaps from the posterior trunk were used to repair their adjacent deep wounds.These defects were repaired with 18 latissimus dorsi musculocutaneous flaps pedicle with thoracodorsal artery(one combined with pectoralis major musculocutaneous flap,and 3 combined with iliolumbar skin flap),one latissimus dorsi musculocutaneous flap pedicle with the posterior branches of posterior intercostal arteries and lumbar arteries,and three lower trapezius musculocutaneous flaps respectively after debridement and resection of ulcer or tumor.ResultsWound infection and partial necrosis occurred in one case each.The wound achieved primary healing except re-debridement on one infected flap mentioned above and second-stage skin grafting on 4 donor sites and one partial necrotic flap.After a follow-up of 3 to 24 months,the function and configuration were appropriately satisfactory.Conclusion The transplantation of pedicled myocutaneous flaps from the posterior trunk would be safe,effective and reliable in the management of patients with deep wounds in the neck,chest and upper extrimity.更多还原