Reconstruction of postburn facial scar contracture deformity with expanded flap containing cervical cutaneous branch of transverse cervical artery
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摘要: 目的 观察颈横动脉(TCA)颈段皮支扩张皮瓣整复面部烧伤后瘢痕挛缩畸形的效果。 方法 2011年9月—2016年1月,笔者单位收治6例面部烧伤后瘢痕挛缩畸形患者,瘢痕面积12 cm×10 cm~20 cm×15 cm,采用TCA颈段皮支扩张皮瓣整复。将1个300 mL或350 mL扩张器埋置于前胸部进行超量注水扩张,其中1例患者进行了双侧前胸部皮肤扩张。本组患者注水周期6~15个月,注水量1 260~2 010 mL。2例患者因皮瓣血运不佳,另行皮瓣延迟术。扩张完毕后掀起皮瓣(面积20 cm×7 cm~25 cm×9 cm)无张力转移覆盖瘢痕切除后创面,供区直接缝合,3~4周后行皮瓣断蒂和局部修整术。 结果 7个皮瓣均成活,其中2个创面延迟愈合。随访4~15个月,皮瓣厚度薄,颜色与面部皮肤相近,质地柔软,感觉存在。 结论 TCA颈段皮支扩张皮瓣质地、颜色佳,厚度薄,可用面积大且供区损伤小,是整复面部烧伤后瘢痕挛缩畸形的较好选择。Abstract: Objective To observe the effect of expanded flap containing cervical cutaneous branch of transverse cervical artery (TCA) on reconstruction of postburn facial scar contracture deformity. Methods Six patients with postburn facial scar contracture deformity, hospitalized from September 2011 to January 2016, with the scar area ranging from 12 cm×10 cm to 20 cm×15 cm, were reconstructed with expanded flap containing cervical cutaneous branch of TCA. One expander of 300 mL or 350 mL implanted in anterior pectoral area was injected for excessive expanding; one patient was conducted with expansion in both sides of the anterior pectoral area. The volume of expansion varied from 1 260 to 2 010 mL after 6 to 15 months. Two flaps were delayed for their poor blood supply. After expansion, the flaps with the area ranging from 20 cm×7 cm to 25 cm×9 cm were transferred with no tension to cover the wounds after scar excision. The donor site was closed directly. Three to four weeks later, the vascular pedicle was dissected combined with local reconstruct surgery. Results All the flaps survived, with two wounds suffered delayed healing. During the follow-up for 4 to 15 months, the flaps were thin and soft with good sensation and color close to the facial skin. Conclusions Expanded flap containing cervical cutaneous branch of TCA is a good choice for reconstruction of postburn facial scar contracture deformity because of its good texture and color, thin thickness, as well as it can provide large avaliable area while causing less injury to the donor site.
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Key words:
- Burns /
- Face /
- Cicatrix /
- Contracture /
- Surgical flaps /
- Tissue expansion devices /
- Transverse cervical artery
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