【摘要】 目的探讨扩张的邻位或远位轴型筋膜皮瓣,在修复面、颈、手部大面积缺损中的效果和优越性。方法在胸、背、腹部深筋膜下,放置1~2枚400~800 ml的矩形扩张器。皮瓣蒂部包含颈横动脉主干及降支、胸肩峰动脉皮穿支、旋髂浅动脉或腹壁浅动脉。扩张的轴型筋膜皮瓣可经1~2次延迟,然后转移至病变切除后的创面。转移后的皮瓣可再次扩张以修复残余病变。结果修复各种病变共35例。除3例皮瓣远端坏死外,其余32例全部成活。最大皮瓣面积40 cm×9 cm。经术后1~12年随访观察,皮瓣色泽正常,柔韧性、延展性好,功能恢复满意,外形美观。结论扩张的邻位或远位轴型筋膜皮瓣技术,不仅使移植皮瓣的血运更加丰富、面积显著增加、厚度明显变薄,而且使皮肤的颜色、质地、感觉均与修复区较相匹配。用其修复面、颈、手部大面积缺损是一种安全可靠、实用有效的方法。更多还原

【Abstract】 Objective To study the clinical significance of the expanded distant or contiguous axial-pattern fasciocutaneous flap used in repairing large facial or cervical or hand defects.Methods One or two rectangular soft tissue expanders were implanted under the deep fascia of the chest or back or abdo-men,and the axial-pattern fasciocutaneous flap was based on the descending branches or stem of trans-verse cervical artery,or cutaneous branches of thoracoacromial artery,or superficial iliac circumflex arter-y and superficial epigastric artery.After once or twice flap delaying,the expanded axial-pattern fasciocu-taneous flaps were transfered to the defects,and the survived flaps could be expanded again to reconstruct the other defects.Results 35 cases were treated from 1992 to 2005 and followed up,in which 32 cases survived completely,only 3 were necrotic in the distance of the flap.The largest area of flap was 40 cm ×9 cm.The follow-up revealed the superiority of the expanded axial-pattern fasciocutaneous flap,such as its good colour and contour,ideal flexibility and contribution to functional recovery.Conclusion The expanded distant or contiguous axial-pattern fasciocutaneous flap is a kind of technique with good flap blood supply,large area of flap and suitable flap thickness.The skin colour,its quality nature and sense are matched with the area around the defects.It avoids damage to the main veins and arteries of donor sites,decreased scars of donor sites.It is an effective and practical approach to resconstruct the large fa-cial or cervical or hand defects.更多还原