开胸术后肋软骨炎的整形外科治疗

目的探讨开胸术后肋软骨炎的治疗方法。方法对单根的肋软骨炎,在压痛最明显处直接切除受累的肋软骨;对胸上部多根肋软骨炎,可在胸部正中(开胸之瘢痕处)切开,切除受累的肋软骨;对胸下部、肋弓处肋软骨炎,除在胸部正中切开外,再向外下沿肋弓切开,形成以上部为蒂的胸部皮瓣,再切除受累的肋软骨;对肋软骨炎伴胸锁关节炎者,在胸部正中切开,形成一侧的胸部皮瓣,将受累的肋软骨及胸锁关节切除,应用胸大肌瓣转移填塞胸锁关节缺损处。术后行滴注引流,应用敏感抗生素。结果本组7例,2周后伤口愈合,效果良好。结论彻底清除感染的肋软骨是治疗开胸术后肋软骨炎的有效方法。

Plastic Surgery for costal chondritis after thoracotomy

Objective To explore the surgical treatment technique for costal chondritis after thoracotomy.Methods For those with chondritis of a single rid,the involved costal cartilage is directly cut from the obvious pressure pain spot.For those with chondritis of many ribs,cut the ribs from the scar of thoracotomy.For those with chondritis in inferior chest and arcus costalis,make an incision at the median of chest,resect the infected costal cartilage along the arcus costalis,harvest the flap with superior pedicle to close the defects.For those with chondritis in sternoclavicular joint,remove the involved ribs and joints,make the pectoralis major musculocutaneous flap on one side of the chest,then transfer the flap to cover the defects.For all the patients,instillation and drainage are performed and antibiotics should be applied.Results All of the 7 patients show good results,the wounds healed completely after 2 weeks.Conclusion Thorough excision of the infected costal cartilage is an effictive technique for the treatment of chondritis after thoracotomy.