【摘要】 目的提高臂部大面积创面的外科治疗效果,减少供区瘢痕。方法应用侧胸背部扩张带蒂皮瓣Ⅲ期手术(Ⅰ期扩张器植入、Ⅱ期扩张带蒂皮瓣修复、ⅠⅡ期断蒂),于侧胸背部埋置扩张器,经充分扩张后,取出扩张器,形成蒂在胸背部的扩张皮瓣,直接移转至臂部修复皮肤软组织缺损,供区直接缝合。结果本组8例,大面积黑痣3例,瘢痕4例,难愈性创面1例,皮瓣均成活,手术切口Ⅰ期愈合,存活皮瓣色泽与邻近皮肤差异不大,供区无需植皮,瘢痕反应轻。术后1年切口瘢痕不明显。结论侧胸背部扩张带蒂皮瓣是修复臂部大面积皮肤软组织缺损的安全可靠方法,优点突出,但治疗时间长也是不可忽视的问题。更多还原

【Abstract】 Objective To improve the surgical treatment effect of large area wound in the arm and reduce the scar of donor area.Methods Lateral thoracic and back pedicle flap Ⅲ surgery(implantation of the stent, the expansion of pedicle flap, pedicle period) is applied. Dilator is embedded in the side of the chest and back, remove the dilator after full expansion, form pedicle flap in the chest and back, which transfer to the upper arm to repair soft tissue defects, the donor site was sutured directly. Results There are eight patients in the group, including three cases of large mole, four cases of scar, one case of skin ulcers. All the flaps survived and the incision healed in I stage. There is little difference between the color of viable skin flap and that of adjacent skin. Donor area does not need skin graft, and scar reaction is light. One year later, the scar is not obvious. Conclusion Dilated pedicle flap of lateral chest and back is a safe and reliable method to repair large areas of the upper arm skin and soft tissue defects, with outstanding advantages, but the treatment needs a long time which cannot be ignored.更多还原