岛状胸大肌肌皮瓣修复颌颈部电烧伤

目的 了解应用岛状胸大肌肌皮瓣修复颌颈部高压电烧伤组织缺损的效果.方法 2001年8月-2007年12月,笔者单位对18例高压电烧伤患者的颌颈部软组织大面积缺损创面,应用岛状胸大肌肌皮瓣修复.早期扩创后移植皮瓣8例、感染创面移植皮瓣10例,皮瓣面积12 cm×10cm～16 cm×13 cm,供区移植自体大张中厚皮.结果 所有皮瓣均成活,4例皮瓣远端创缘表皮出现坏死带(长2～5 cm、宽1～2 cm),创缘局部裂开2例,经换药或再次缝合治愈.术后随访6个月～3年,患者颌颈部外观和功能恢复较满意.结论 岛状胸大肌肌皮瓣具有组织量大、肌腹扁平、血供丰富的优点,能够较好修复颌颈部较大面积深部组织裸露创面.

Repair of high-voltage electric burn in jaw and neck region with insular pectoralis major myocutaneous flap

Objective To evaluate the effect of insular pectoralis major myocutaneous flap on repair of jaw and neck tissue defect as a result of high-voltage electric burn. Methods Eighteen patients with large area tissue defect in jaw and neck caused by high-voltage electric burn hospitalized from August 2001 to December 2007 were repaired with insular pectoraiis major myocutaneous flap. The flaps(from 12 cm×10 cm to 16 cm × 13 cm) was transplanted in 8 patients after early wound debridement, and in I0 patients on infected wounds. Results All flaps survived wells except in 4 patients necrotic area(length 2-5 cm, width 1-2 cm) appeared in the distal wound edge, localized dehiscence of wound edge in 2 cases, which were healed after dressing change or secondary suturing. Patients were followed up from 6 months to 3 years, and the appearance and function were satisfactory. Conclusions Pectoralis major muscle island myocutaneous flap has the advantage of large tissue mass, with thin and flat muscle belly, and rich blood supply, which is suitable for repair of large deep tissue defect in jaw and neck.