【作者】 王继华； 杨云； 朱礼昆； 张景波； 何永静； 李颖；

【Author】 Wang ji-hua Yang Yun,Zhu Li kun,Zhang Jing-Bo, He yong-jing,Li ying Department of Plastic Surgery,the Second Affiliated Hospital of Kunming Medical College

【机构】 昆明医学院第二附属医院整形外科；

【摘要】 目的探讨应用扩张后胸三角皮瓣修复面颈部较大面积皮肤软组织缺损的效果方法自2006年以来,对我科收治的20例患者,其中17例面部瘢痕、2例颈部瘢痕和1例面部黑毛痣,在胸三角区植入300～400ml柱形扩张器,经3～5个月注水,注水后容量为500～1000ml获得足够的皮肤后,切除面颈部瘢痕,创面应用扩张后胸三角皮瓣转移修复,1月后断蒂,利用蒂部皮瓣修复剩余瘢痕切除后的创面结果:共植入22个扩张器,除1例扩张器外露,1例出现感染终止扩张,18例(20个)扩张器顺利扩张。皮瓣转移后2例皮瓣远端发生少量坏死,经换药或植皮后创面愈合,其余16例(18个扩张器)转移的皮瓣全部成活,皮瓣色泽厚度质地接近正常部位,患者和家属均满意,取得很好的修复效果结论对于面颈部瘢痕或体表病变手术后的较大面积皮肤软组织缺损,应用扩张后胸三角皮瓣修复是一种很好的方法更多还原

【Abstract】 Objective:To explore the effect of dilated deltopectoral flaps of repairing large area of skin and soft tissue defects in face and neck.Methods:Since 2006,the experiment of implanting cylindrical expanders with volume of 300～400ml in 20 cases of patients in this research have been implemented,including 17 cases of facial scar,2 cases of cervical scar and 1 case of facial black pigmented nevus.Plenty of skin was obtained after 3 to 5 months injection of steriled water leading to 500～1000 ml volume of expanding space,following the implanting expanders. Then the facial and cervial scars were removed.The expanded deltopectoral flaps were used for repairing the surface of wound.After the skin flap pedicle division one month later,the skin flap pedicle was employed into restoring other surface of wound produced by removing residual scars.Results:18 cases of expanding experiment were successful in the total 20 cases with the exception of 1 case of expander exposure,1 case of termination of the expansion by infection.After transferring the skin flaps,there were slight necrosis in vicinity of distal end of skin flaps, which were healed afer refil of drug or skin-grafting.The other 16 cases of transferred skin flaps all survived with die normal location of color,texture and thickness of flaps, which pleased the patients and their family.Conclusion:The method of application of dilated delropectoral for repairing large area skin and soft tissue on face and neck was excellent.更多还原