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内镜辅助下与传统方式切取背阔肌游离肌皮瓣供区并发症的比较

Donor-site morbidity comparison between endoscopically assisted and traditional harvest of free latissimus dorsi muscle flap.

作者信息

Lin C H, Wei F C, Levin L S, Chen M C

机构信息

Department of Plastic and Reconstructive Surgery at Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Plast Reconstr Surg. 1999 Sep;104(4):1070-7; quiz 1078.

Abstract

Endoscopically assisted harvest of free latissimus dorsi muscle flaps is being used more frequently in reconstructive microsurgery because it requires a smaller incision and leaves a more acceptable scar in the donor site. Donor-site morbidity was compared between groups of 22 latissimus dorsi muscles harvested using the endoscopically assisted technique and 26 using the traditional technique. The results revealed no statistically significant differences in the amount of intraoperative bleeding, the incidence of postoperative hematoma and seroma, and the incidence of donor-site wound infection as assessed by the surgeon. However, a patient questionnaire revealed that even though it did not reach a statistically significant difference, endoscopically assisted harvest of the latissimus dorsi muscle had less pain and allowed earlier and better movement of the upper extremity of the donor site. The patients' attitudes and feelings about the scar and overall satisfaction were also higher in the endoscopic group, which demonstrated a statistically significant difference.

摘要

内镜辅助下切取背阔肌游离肌皮瓣在重建显微外科中的应用越来越频繁,因为它所需切口较小,且供区瘢痕更易被接受。对采用内镜辅助技术切取的22例背阔肌和采用传统技术切取的26例背阔肌的供区并发症进行了比较。结果显示,术中出血量、术后血肿和血清肿发生率以及外科医生评估的供区伤口感染发生率在统计学上无显著差异。然而,一份患者调查问卷显示,尽管未达到统计学显著差异,但内镜辅助切取背阔肌的疼痛较轻,供区上肢能更早、更好地活动。内镜组患者对瘢痕的态度和感受以及总体满意度也更高,这显示出统计学上的显著差异。

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