横过中线的肩胛游离皮瓣移植

目的 鉴于肩胛背部受旋肩胛动脉浅皮支、胸背动脉肌皮穿支、颈横动脉浅皮支及肋间后动脉皮支重叠供血，互相存在广泛的吻合网，探讨是否可以安全的形成扩大的肩胛皮瓣。方法本组应用横过脊柱中线的肩胛游离皮瓣移植，治疗下颌颈部严重瘢痕挛缩８例。结果 除２例远１５cm而达对侧肩胛区，扩大了肩胛皮瓣的切取面积，增加了临床应用范围。结论 横过中线的肩胛皮瓣设计应以旋肩胛动脉水平支为轴线，与其成角设计可能出现远端血障碍。

The scapular free flap crossing the dorsal midline]

OBJECTIVE: A large defect needs a large flap to repair. This clinical study was to explore the possibility and safeness of transferring the extended scapular free flap. METHOD: We have used the transverse scapular flap to reconstruct large defects in the mandibular or cervical region in 8 patients. The flap was designed to cross the midline of the back as far as 15 cm. The largest flap measured 31 x 34 cm. RESULTS: Of the 8 flaps, six survived completely; local epidermal necrosis appeared in two. CONCLUSION: The free scapular flap supplied by a single circumflex scapular vascular pedicle can be safely extended beyond the midline of the back. The flap axis is the horizontal branch of the circumflex scapular vessel.