扩张后胸三角皮瓣修复面颈部瘢痕

目的 探讨面颈部烧伤后瘢痕的修复方法.方法 单侧或双侧胸三角皮瓣预扩张后,带蒂转移修复102例烧伤患者面颈部瘢痕.术中先切除松解面部瘢痕,使眼、口、鼻恢复至正常解剖位置,再将面部瘢痕瓣翻转与胸三角皮瓣蒂部形成铰链进而封闭蒂部创面,3周后行皮瓣延迟术,断蒂修复剩余的面颈部瘢痕.结果 94例患者的皮瓣一次性成活,效果良好.7例患者皮瓣转移后,出现单侧皮瓣尖端血运障碍.自行愈合后色素减退;1例患者出现单侧皮瓣坏死,植皮后愈合.结论 扩张后胸三角皮瓣是修复较大面积面颈部瘢痕的有效方法.

Repair of facial and cervical scars with expanded deltopectoral flaps

Objective To explore the methods for repair of facial and cervical scars after burn.Methods One hundred and two patients with facial and cervical scars as a result of burn injury were repaired by unilateral or bilateral dehopectoral flaps after expansion with pedicles.First,facial scars were excised and contractures were released to restore eye.mouth and nose to normal anatomical position.The faeial scar flaps were overturned to join with the pedicles of dehopectoral flap for closing the wounds.The residual wounds were repaired by delayed flaps without pedieles 3 weeks later. Results Among 102 patients,the flaps survived well in 94 cases,and blood supply insufficiency was found in distal end of unilateral flap in 7 cases (depigmentation after primary healing).Necrosis of unilateral flap occurred in one patient.and it healed after skin grafting. Conclusion Expanded dehopectoral flap is efficacious procedure for repair of massive cervical and facial scars.