胸三角皮瓣修复乳癌术后复发病灶及放射性溃疡

目的探讨乳癌根治术后复发病灶及放射性溃疡的胸壁大块深度缺损修复方法。方法采用对侧以第2、3肋间前胸穿支为血管蒂的岛状皮瓣修复乳癌根治术后局部复发病灶清除后缺损创面4例及放射性溃疡8例。结果12例皮瓣全部成活，其中1例皮瓣远端表皮坏死经换药后痊愈。随访6个月-4年，伤口愈合稳定，外形恢复满意。结论以第2、3肋间前胸穿支为血管蒂的岛状皮瓣是一期修复乳癌根治术后局部复发病灶的清除缺损创面及放射性溃疡简便易行的理想方法。

Repair of major chest wall defects caused by recurrent lesion or radiation ulcer after radical mastectomy with delto-pectoral flap

Objective To evaluate a repair approach to major defects of chest wall caused by recurrent lesion or radiation ulcer after radical masteetomy. Methods The delto-pectoral island flaps were applied to repair major defects of chest wall. The blood supply of the flap was from the 2nd and 3rd anterior perforator of the internal mammary artery. 4 patients with defects of chest wall caused by recurrent cancer lesion and 8 patients caused by radiation ulcer received the pedieled flap after resection of lesion or ulcer. Results All the 12 flaps survived, in which flap necrosis at the distal end occurred in 1 case and it was cured after changing dress. After a follow-up of 6 months to 4 years, the flap healed and the cosmetic effect was satisfactory. Conclusions This method is an ideal method for repair of stage I major defects of chest wall caused by recurrent lesion and radiation ulcer after radical mastectomy.