Ogawa Rei, Hyakusoku Hiko, Iwakiri Itaru, Akaishi Satoshi
Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan.
Ann Plast Surg. 2004 Feb;52(2):216-9. doi: 10.1097/01.SAP.0000070640.49193.96.
The authors have reconstructed neck scar contractures with "super-thin flaps" (subdermal vascular network [SVN] flaps) since 1994 and have used the circumflex scapular artery and veins (CSAV) and dorsal intercostal perforators (DICPs) to augment the blood flow in the distal portion of the flaps. These free microvascular augmentations enlarge the flap survival area. In this report, the authors describe a severe neck scar contracture reconstructed with a ninth DICP augmented "super-thin flap." The patient was a 51-year-old woman with severe flame burns on 44% of her total body surface area, resulting from a cooking accident. After emergency skin grafting, the patient had a severe scar contracture and intractable ulcer of the anterior neck. CSAV and a ninth DICP augmented occipito-cervico-dorsal (OCD) "super-thin flap" transfer were used to reconstruct the anterior neck. The flap size was 28 x 15 cm, and it survived completely. The cervico-mental angle was clear and esthetically pleasing, and not only the aesthetic results but also the functional results were excellent.
自1994年以来，作者一直使用“超薄皮瓣”（皮下血管网[SVN]皮瓣）修复颈部瘢痕挛缩，并利用旋肩胛动静脉（CSAV）和肋间后穿支（DICPs）增加皮瓣远端的血流。这些游离微血管增血术扩大了皮瓣存活面积。在本报告中，作者描述了一例采用第九肋间后穿支增血的“超薄皮瓣”修复的严重颈部瘢痕挛缩病例。患者为一名51岁女性，因烹饪事故导致全身44%体表面积遭受严重火焰烧伤。急诊植皮后，患者出现严重的瘢痕挛缩和颈部前方顽固性溃疡。采用CSAV和第九肋间后穿支增血的枕颈背（OCD）“超薄皮瓣”转移修复颈部前方。皮瓣大小为28×15 cm，完全存活。颈颌角清晰且美观，不仅美学效果良好，功能效果也极佳。
