Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns

Ji Peng; Cao Tao; Zhang Zhi; Zhang Yue; Hu Shijun; Wang Junchang; Han Chao; Wang Jing; Shi Jihong; Hu Dahai; Tao Ke

doi:10.3760/cma.j.cn501120-20211231-00426

Volume 38 Issue 4

Apr. 2022

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(4): 328-334

Ju YK,Fang BR.Research advances on the mechanism of extracellular vesicles of adipose-derived mesenchymal stem cells in promoting wound angiogenesis[J].Chin J Burns Wounds,2023,39(1):85-90.DOI: 10.3760/cma.j.cn501225-20220322-00080.

Citation:

Ji P, Cao T, Zhang Z, et al. Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns[J]. Chin J Burns Wounds, 2022, 38(4): 328-334. DOI: 10.3760/cma.j.cn501120-20211231-00426.

Citation:

PDF( 16905 KB)

Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns

doi: 10.3760/cma.j.cn501120-20211231-00426

1.
Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
2.
Department of Burns and Plastic Surgery, Bozhou City People's Hospital, Bozhou 236814, China
3.
Department of Burns and Plastic Surgery, Shihezi City People's Hospital, Shihezi 832099, China

Funds:

General Program of National Natural Science Foundation of China 82172209

More Information

Corresponding author: Tao Ke, Email: taoke918@fmmu.edu.cn
Received Date: 2021-12-31

Abstract

Abstract

Objective To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14^th day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. Results On the 14^th day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14^th day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.
- Burns,
- Neck,
- Cicatrix,
- Perforator flap,
- Dilatation,
- Contracture

FullText(HTML)

References(36)

References

[1]	吴琛,邹同荣,陈思思.扩张后胸三角皮瓣修复颈部瘢痕挛缩畸形的应用[J].中国美容整形外科杂志,2019,30(7):408-410,432.DOI: 10.3969/j.issn.1673-7040.2019.07.007.
[2]	唐银科,楚菲菲,马显杰.四类预扩张皮瓣对面颈部亚单位病损的修复效果分析[J].中华整形外科杂志,2020,36(10):1088-1094.DOI: 10.3760/cma.j.cn114453-20200507-00268.
[3]	刘士强,马显杰.皮肤软组织扩张术的应用进展与展望[J].中华整形外科杂志,2019,35(10):949-952.DOI: 10.3760/cma.j.issn.1009-4598.2019.10.001.
[4]	冯登超,武斌,杨喜明.胸背动脉穿支皮瓣游离移植修复面颈部大面积瘢痕的临床疗效[J].西部医学,2016,28(4):487-489.DOI: 10.3969/j.issn.1672-3511.2016.04.012.
[5]	ZeidermanMR, PuLLQ. Contemporary reconstruction after complex facial trauma[J/OL]. Burns Trauma,2020,8:tkaa00 3[2021-12-31].https://pubmed.ncbi.nlm.nih.gov/32341916/.DOI: 10.1093/burnst/tkaa003.
[6]	AkitaS, HayashidaK, TakakiS, et al. The neck burn scar contracture: a concept of effective treatment[J/OL].Burns Trauma,2017,5:22[2021-12-31]. https://pubmed.ncbi.nlm.nih.gov/28717655/.DOI: 10.1186/s41038-017-0086-8.
[7]	蔡海军,谭静雷.扩张后随意型皮瓣修复术治疗面颈部烧伤后瘢痕[J].中华全科医学,2016,14(5):777-779.DOI: 10.16766/j.cnki.issn.1674-4152.2016.05.027.
[8]	ChenBG,SongHF,XuMH,et al.Reconstruction of cica-contracture on the face and neck with skin flap and expanded skin flap pedicled by anterior branch of transverse cervical artery[J].J Craniomaxillofac Surg,2016,44(9):1280-1286.DOI: 10.1016/j.jcms.2016.04.020.
[9]	OgawaR.Surgery for scar revision and reduction: from primary closure to flap surgery[J/OL].Burns Trauma,2019,7:7[2021-12-31]. https://pubmed.ncbi.nlm.nih.gov/30891462/.DOI: 10.1186/s41038-019-0144-5.
[10]	任静,韩岩,王白石,等.全厚植皮与扩张胸三角皮瓣转移修复面部大面积皮肤缺损[J].中国美容整形外科杂志,2017,28(10):596-598.DOI: 10.3969/j.issn.1673-7040.2017.10.005.
[11]	SongBQ, ZhaoJH, GuoSZ,et al.Repair of facial scars by the free expanded deltopectoral flap[J].Plast Reconstr Surg,2013,131(2):200e-208e.DOI: 10.1097/PRS.0b013e3182789c02.
[12]	何秀叶,宋慧锋,许明火,等.超量预制颌颈部扩张皮瓣进行面颊部亚单位的美学修复[J].中华医学美学美容杂志,2017,23(4):226-228.DOI: 10.3760/cma.j.issn.1671-0290.2017.04.004.
[13]	杨喆,刘伟,李养群,等.扩张的颈肩峰区锁骨上皮瓣修复面颈部软组织缺损[J].中国美容医学,2015,24(9):1-5.DOI: 10.15909/j.cnki.cn61-1347/r.000429.
[14]	于东宁,沈余明,陈欣.带血管蒂的邻位动脉穿支轴型皮瓣修复患者面颈部瘢痕畸形的效果[J].中华烧伤杂志,2019,35(12):848-854.DOI: 10.3760/cma.j.issn.1009-2587.2019.12.004.
[15]	马显杰.颈横动脉颈段皮支轴型皮瓣的临床应用[J].中华整形烧伤外科杂志,1993,9(1):22-24.DOI: 10.3760/j.issn:1009-4598.1993.01.014.
[16]	RamirezCA,FernandesRP.The supraclavicular artery island and trapezius myocutaneous flaps in head and neck reconstruction[J].Oral Maxillofac Surg Clin North Am,2014,26(3):411-420.DOI: 10.1016/j.coms.2014.05.009.
[17]	杨忠全,郭志权,岳瑞祥,等.2800例面颈部创面的美学修复[J].中华烧伤杂志,2012,28(4):269-270.DOI: 10.3760/cma.j.issn.1009-2587.2012.04.012.
[18]	王爱武,杨壮群.扩张胸背动脉穿支皮瓣修复面颈部瘢痕远期疗效观察[J].中国医疗美容,2016,6(11):31-33.DOI: 10.3969/j.issn.2095-0721.2016.11.016.
[19]	侯健,宋慧锋,陈保国,等.预扩张颈横动脉前穿支皮瓣与预扩张胸部随意皮瓣接力整复大面积面颈部瘢痕的临床效果[J]. 中华烧伤杂志,2021,37(4):350-355.DOI: 10.3760/cma.j.cn501120-20201023-00445.
[20]	SongBQ,XiaoB,LiuCH,et al. Neck burn reconstruction with pre-expanded scapular free flaps[J].Burns,2015,41(3):624-630.DOI: 10.1016/j.burns.2014.08.015.
[21]	ZhangYX, HayakawaTJ, LevinLS, et al. The economy in autologous tissue transfer: part 1. The kiss flap technique[J]. Plast Reconstr Surg,2016,137(3):1018-1030.DOI: 10.1097/01.prs.0000479971.99309.21.
[22]	TashiroK,YamashitaS,ArakiJ,et al. Preoperative color Doppler ultrasonographic examination in the planning of thoracodorsal artery perforator flap with capillary perforators[J].J Plast Reconstr Aesthet Surg,2016,69(3):346-350.DOI: 10.1016/j.bjps.2015.10.026.
[23]	MiyamotoS, ArikawaM, KagayaY, et al.Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study[J].J Plast Reconstr Aesthet Surg,2019,72(1):78-84.DOI: 10.1016/j.bjps.2018.08.026.
[24]	FerrariM, SahovalerA, ChanHHL, et al.Scapular tip-thoracodorsal artery perforator free flap for total/subtotal glossectomy defects: case series and conformance study[J].Oral Oncol,2020,105:104660.DOI: 10.1016/j.oraloncology.2020.104660.
[25]	黄广涛,魏在荣,黄丽,等.二纵三横法在胸背动脉穿支皮瓣穿支定位及深度创面修复中的临床应用效果[J].中华烧伤与创面修复杂志,2022,38(2):165-169.DOI: 10.3760/cma.j.cn501120-20201207-00519.
[26]	王晓峰,李学渊,丁文全,等.胸背动脉穿支皮瓣的显微解剖及临床应用[J].中华显微外科杂志,2020,43(5):481-485.DOI: 10.3760/cma.j.cn441206-20200528-00244.
[27]	BidrosRS, MetzingerSE, GuerraAB. The thoracodorsal artery perforator-scapular osteocutaneous (TDAP-SOC) flap for reconstruction of palatal and maxillary defects[J]. Ann Plast Surg,2005,54(1):59-65. DOI: 10.1097/01.sap.0000139561.64564.d7.
[28]	董琛,余州,马显杰.皮肤软组织扩张方法与机制的研究进展[J].中华实验外科杂志,2019,36(8):1513-1517.DOI: 10.3760/cma.j.issn.1001-9030.2019.08.057.
[29]	AustadED, PasykKA, McClatcheyKD, et al.Histomorphologic evaluation of guinea pig skin and soft tissue after controlled tissue expansion[J].Plast Reconstr Surg,1982,70(6):704-710.DOI: 10.1097/00006534-198212000-00008.
[30]	LiHZ,WangZ,GuB,et al.Postburn neck reconstruction with preexpanded upper back perforator flaps: free-style design and an update of treatment strategies[J].Ann Plast Surg,2018,81(1):45-49.DOI: 10.1097/SAP.0000000000001491.
[31]	刘毅.重视供区的美容修复[J].中华烧伤杂志,2020,36(2):81-84.DOI: 10.3760/cma.j.issn.1009-2587.2020.02.001.
[32]	杜伟力,沈余明,胡骁骅,等.供瓣区美学修复方法的探讨[J].中华烧伤杂志,2020,36(2):97-105.DOI: 10.3760/cma.j.issn.1009-2587.2020.02.004.
[33]	TawaP, FoirestC, TankéréF, et al. Tongue reconstruction by thoracodorsal perforator flap: a new harvesting technique to reduce morbidity[J]. Ann Chir Plast Esthet,2019,64(4):368-373. DOI: 10.1016/j.anplas.2019.01.001.
[34]	LengletM, DastS, DessenaL, et al. Extension of the thoracodorsal artery perforator flap's pedicle: anatomical study[J]. Ann Chir Plast Esthet,2017,62(4):327-331. DOI: 10.1016/j.anplas.2017.01.001.
[35]	胡长青,连勇,白晓亮,等.游离胸背动脉穿支皮瓣修复小腿远端及足踝部创面九例[J].中华烧伤杂志,2018,34(4):240-242.DOI: 10.3760/cma.j.issn.1009-2587.2018.04.009.
[36]	马显杰, 丁健科. 皮肤软组织扩张术在儿童体表病损修复中的应用[J]. 中华烧伤与创面修复杂志,2022, 38(4): 301-305. DOI: 10.3760/cma.j.cn501120-20211019-00359.

Relative Articles

[1]	Cai Weixia, Zheng Zhao, Liu Jiaqi, Liu Yang, Zhang Ting, Ji Peng, Tian Chenyang. Effect of rat platelet-rich plasma gel on autologous adipose-derived mesenchymal stem cells overexpressing glia-derived neurotrophic factor[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(12): 1176-1183. doi: 10.3760/cma.j.cn501225-20240408-00126
[2]	Chen Yiqi, Zhou Yingqian, Wei Qian, Xie Xiaoye, Liu Xinzhu, Li Dawei, Shen Chuan'an. Effects of gelatin methacrylate anhydride hydrogel loaded with small extracellular vesicles derived from human umbilical cord mesenchymal stem cells in the treatment of full-thickness skin defect wounds in mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(4): 323-332. doi: 10.3760/cma.j.cn501225-20231218-00248
[3]	Chen Lianglong, Yu Shengxiang, Ma Jun, Gao Yanbin, Yang Lei. Research progress of biomaterials in promoting wound vascularization[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(4): 381-385. doi: 10.3760/cma.j.cn501225-20220626-00261
[4]	Cao Tao, Xiao Dan, Ji Peng, Zhang Zhi, Cai Weixia, Han Chao, Li Wen, Tao Ke. Effects of exosomes from hepatocyte growth factor-modified human adipose mesenchymal stem cells on full-thickness skin defect in diabetic mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(11): 1004-1013. doi: 10.3760/cma.j.cn501225-20220731-00330
[5]	Liu Wenjian, Liu Dewu. Research advances on mesenchymal stem cell-derived extracellular vesicles in promoting angiogenesis of diabetic ulcers[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(4): 393-399. doi: 10.3760/cma.j.cn501120-20201207-00520
[6]	Tang Lijun, Zhang Xiaowei, Jin Junjun, Li Xiaomei, Xu Gang. Research advances on mechanism of exosomes derived from adipose derived stem cells in the treatment of chronic wounds[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(2): 191-195. doi: 10.3760/cma.j.cn501120-20200220-00076
[7]	Cao Xiaozan, Xie Ting, Lu Shuliang. Receptor pathways of glycated basic fibroblast growth factor affecting the proliferation and vascularization of human dermal microvascular endothelial cells[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(1): 17-24. doi: 10.3760/cma.j.cn501120-20200916-00412
[8]	Yang Qinxin, Wang Dali, Xu Guangchao, Deng Chengliang, Wei Zairong. Advances in the research of effects of epithelial-mesenchymal interaction on wound healing and scar formation[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(5): 405-410. doi: 10.3760/cma.j.cn501120-20190827-00362
[9]	Shi Chenshuo, Wang Dali, Sun Jin, Yang Qinxin, Wei Zairong, Deng Chengliang, Xu Guangchao, Huang Guangtao, Xiao Shun′e. Influence of human amniotic mesenchymal stem cells on macrophage phenotypes and inflammatory factors in full-thickness skin wounds of mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(4): 288-296. doi: 10.3760/cma.j.cn501120-20191120-00438
[10]	Lei Xiaoxuan, Xu Pengcheng, Zhang Lei, Pang Mengru, Tian Ju, Cheng Biao. Effects of human adipose-derived mesenchymal stem cells and platelet-rich plasma on healing of wounds with full-thickness skin defects in mice[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(12): 887-894. doi: 10.3760/cma.j.issn.1009-2587.2018.12.013
[11]	Zhou Wangbiao, Li Yeyang. Advances in the research of role of integrin-linked kinase in angiogenesis[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2017, 33(5): 317-320. doi: 10.3760/cma.j.issn.1009-2587.2017.05.013
[12]	Shao Huawei, Wang Xin′gang, You Chuan′gang, Han Chunmao. Advances in the research of negative-pressure wound therapy inducing the vascularization of dermal substitute[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2017, 33(8): 523-525. doi: 10.3760/cma.j.issn.1009-2587.2017.08.019
[13]	Hu Dahai, Zhang Wei. To enhance study on translation and application of mesenchymal stem cells in wound repair[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2017, 33(1): 9-11. doi: 10.3760/cma.j.issn.1009-2587.2017.01.003
[14]	Effects of rat allogeneic adipose-derived stem cells on the early neovascularization of autologous fat transplantation[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2014, 30(6): 512-517. doi: 10.3760/cma.j.issn.1009-2587.2014.06.011
[15]	Liu Lingying, Chai Jiake, Yu Yonghui, Hou Yusen. Advances in the research of the role of mesenchymai stem cell in wound healing[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2014, 30(2): 134-137. doi: 10.3760/cma.j.issn.1009-2587.2014.02.008
[16]	ZHENG Shu-juan, JIA Chi-yu. Present status of research in bone marrow-derived mesenchymai stem cells for promoting the healing of diabetic ulcer[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2012, 28(4): 291-293. doi: 10.3760/cma.j.issn.1009-2587.2012.04.019
[17]	ZHANG Xiang-rong, LIU De-wu, GUO Guang-hua, PENG Yan, ZHONG Oing-ling. Experimental study on the transfection of human vascular endothelial growth factor 165 gene into human marrow mesenchymal stem cells[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2009, 25(4): 261-264.
[18]	WANG Su-yi, HAN Chun-mao, LAI Ping-ping, CEN Hang-hui. Study on differatiation of human mesenchymal stem cells into epidermal cells[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2007, 23(1): 66-68.
[19]	HAN Bing, FU Xiao-bing, HAN Bing, LEI Yong-hong, CHEN Wei, SUN Tong-zhu. Chemotactic effects of burn rat serum on mesenchymal stem cells derived from different sources[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2007, 23(1): 25-28.
[20]	GE Kui, LU Shu-liang, QING Chun, XIE Ting, RONG Liu, NIU Yi -wen, WANG Min-jun, LIAO Zhen-jiang, SHI Ji-xiang. The influence of L-arginine on angiogenesis in burn wounds in diabetic rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2004, 20(4): 210-213.

Supplements(0)

Cited By

Cited by
Periodical cited type(1)
1. 董鸿斐，黄茜，王张鹏，景光旭，史明，李先慧，孙红玉. 胎盘间充质干细胞对胰腺创伤大鼠的保护作用. 解放军医学杂志. 2024(04): 439-448 .
Other cited types(1)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2)

Get Citation

PDF

XML

Article Metrics

Article views (4569) PDF downloads(50)

Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns

doi: 10.3760/cma.j.cn501120-20211231-00426

Abstract

References

Relative Articles

Cited by

Periodical cited type(1)

Other cited types(1)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns

doi: 10.3760/cma.j.cn501120-20211231-00426

Abstract

References

Relative Articles

Cited by

Periodical cited type(1)

Other cited types(1)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content