【摘 要】
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目的 探讨以肩胛下血管为蒂的侧胸皮瓣带蒂转移修复上肢较大面积组织缺损的可行性及临床效果. 方法 2003年6月至2009年9月,我们对5例上肢较大面积组织缺损的患者,应用以肩胛
【机 构】
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绍兴第二医院暨浙江大学附属第一医院绍兴分院整形烧伤外科,绍兴第二医院暨浙江大学附属第一医院绍兴分院骨科,温州医学院附属第二医院骨科,吉林大学附属第一医院手足外科
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目的 探讨以肩胛下血管为蒂的侧胸皮瓣带蒂转移修复上肢较大面积组织缺损的可行性及临床效果. 方法 2003年6月至2009年9月,我们对5例上肢较大面积组织缺损的患者,应用以肩胛下血管为蒂的侧胸皮瓣带蒂转移修复,皮瓣切取面积为23 cm×8 cm～40 cm ×20 cm.术中将肩胛下血管、胸背血管和胸背血管外侧支及其皮穿支等营养血管均包含于皮瓣内.为了减少肌皮穿支的损伤,应在其周围携带2～3 cm宽的背阔肌袖.供瓣区创面直接缝合或移植皮片修复. 结果 单纯侧胸皮瓣带蒂转移4例、侧胸-脐旁联合皮瓣带蒂转移1例.转移的皮瓣除1例远端小部分坏死外,其余全部成活.4例患者获得2～14个月的随访,皮瓣色泽、质地及厚薄较满意,供、受区外形与功能恢复也较满意. 结论 带蒂转移的以肩胛下血管为蒂的侧胸皮瓣血供可靠,转移方便,供瓣区损伤小,是修复上肢较大面积组织缺损的理想方法.
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