颈横动脉颈段皮支预扩张皮瓣治疗瘢痕畸形

目的:总结颈横动脉颈段皮支预扩张皮瓣修复手术整复颈部、腋部严重瘢痕挛缩畸形及软组织缺损的治疗效果.方法:手术分两期:Ⅰ期手术:先埋植扩张器,作预张处理;Ⅱ期手术:扩张器经8周左右间断注水、扩张完全后,术前以超声多普勒血流测定仪测出颈横动脉颈段皮支走向及分布情况,美蓝标记;切除面颈部或腋部瘢痕,松解挛缩病变,根据缺损范围设计手术方案.结果:本组14例,转移皮瓣全部成活.随访6个月～12个月,皮肤颜色与周围正常皮肤较为接近,柔软,无挛缩,有一定程度的感觉,有3例略显臃肿;拉拢缝合供区创面瘢痕增生轻微,外观良好.结论:用颈横动脉颈段皮支预扩张皮瓣修复面颈部及腋部瘢痕及软组织缺损,疗效可靠.

Fourteen Cases of Scar Deformity Treated with Predilation Skin Flap Surgery in Cutaneous Branches of Cervical Segment of Transverse Cervical Artery

Objective： To summarize the therapeutic effect of predilation skin flap repairing surgery in cutaneous branches of cervical segment of transverse cervical artery for the restitution of severe cicatricial contracture and soft tissue defect in cervical and axillary part. Method： The surgical operation was performed in two phases. Phase Ⅰ ： dilator embedment for predilation; Phase Ⅱ ： After 8 weeks＇ intermittent affusion till thorough dilation, strike and disposition of transverse cervical artery in the cutaneous branches of the cervical segment were detected with Doppler flow imaging radiometer and marked with MB before surgery ; the scar on the facial and cervical part or axillary part was excised for the contracture solution, and then the surgical protocol was made based on the defect area. Results： The transplanted skin flaps in all the 14 cases were survived. It was shown in a period of 6 - 12 months follow - up visits that the skin color in the transplanted part was similar to that of the peripheral normal skin with tender texture and sensation in some degree without contracture except three cases showing slight swelling; the roping in saturation area at donor site, wound had a slight scar hyperplasia with a good appearance. Conclusion： Predilation skin flap repairing surgery in cutaneous branches of cervical segment of transverse cervical artery has a reliable effect in the reparation of scared skin and soft tissue defect of the facial, cervical and axillary part.