严重放射性溃疡的修复

目的探讨严重放射性溃疡的修复方法及其临床效果。方法 自１９８８年８月～１９９８年１２月，采用肌瓣或肌皮瓣移位修复严重放射性溃疡１２例，其中胸大肌肌瓣１例，三叶状横形腹直肌肌皮瓣３例，背胸肌肌皮瓣２例，阔筋膜张肌肌皮瓣１例，纵形腹直肌肌眼瓣与阔筋膜张肌肌眼瓣１例，腓肠肌肌瓣１例，臀大肌肌眼瓣１例，下肢巨大别骨肌皮瓣１例，上肢剔骨肌皮瓣１例。结果 肌瓣、肌皮瓣全部成活，伤口期愈合９例，２期愈合３例。２

REPAIR OF SEVERE RADIATION-INDUCED ULCER

Objective To explore a method to repair severe radiation induced ulcer and evaluate its clinical effects.Methods From August 1988 to December 1998,12 cases of severe radiation induced ulcer were treated by muscular or musculocutaneous flap transfer,which included 1 case of pectoralis major muscular flap,3 cases of three lobed transverse rectus abdominis musculocutaneous flap,2 cases of latissimus dorsi musculocutaneous flap,1 case of tensor fascia lata musculocutaneous flap, 1 case of longitudinal rectus abdominis musculocutaneous and tensor fascia lata musculocutaneous flap,1 case of gastrocnemius muscular flap, 1 case of gluteus major musculocutaneous flap,huge filleted musculocutaneous flap from lower limbs in 1 case and from upper limbs in 1 cases. Results All the flaps survived.Primary healing occured in 9 cases and secondary healing in 3 cases.The extensive multiple ulcers in 2 cases were repaired with filleted limb musculocutanous flap,and patients were saved.And in other 3 cases,the chest wall defect as the result of radionecrosis were repaired with simutaneous breast reconstruction.Conclusion Muscular or musculocutaneous flaps have abundant blood supply,they are ideal tissue to fill the cavity and repair the defect,especially in repairing severe radiation induced ulcers.