Wu Yanqiu, Chai Jiake, Chen Minliang
Department of Burns and Plastic Surgery, the 304th Division of General Hospital of PLA, Beijing, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006 Sep;20(9):887-9.
To evaluate the effect of a combined cervical expanded skin flap in repairing cervical scar contracture deformity after burn injury.
From April 2001 to May 2003, 16 cases (10 males and 6 females) of scar contracture deformity in the cervix were treated with expanded clavipectoral axis skin flap combined with reverse axis skin flap. The tissue expanders were embedded under the part containing cutaneous branches of transverse cervical artery in cervical segments and the second and/or the third perforating branch of internal thoracic artery for the first operation. Normal saline was injected regularly. The expanded clavipectoral skin flap and reverse axis skin flap with perforating branch of internal thoracic artery were designed, the scar in the cervix was loosed or dissected according to the size of the skin flaps, the skin flaps were transferred to cover the wound, and the contracture deformity in the cervix was corrected. The size of the flaps were 9 cm x 5 cm-15 cm x 7 cm.
All skin flap survived. The function and appearance of the cervix was improved significantly after 6-30 months follow-up. However, venous return dysfunction in reverse perforating branch of internal thoracic artery occurred in 1 case, and blood circulation was improved after treatment.
Expanded clavipectoral axis skin flap combined with reverse axis skin flap can be used to repair scar contracture deformity in cervix, which lessen scar and abate the chance to contract again.
评估联合应用颈阔肌下扩张皮瓣修复烧伤后颈部瘢痕挛缩畸形的效果。
2001年4月至2003年5月，对16例（男10例，女6例）颈部瘢痕挛缩畸形患者采用锁骨下轴型扩张皮瓣联合胸内动脉穿支逆行轴型皮瓣修复。首次手术时将组织扩张器埋置于颈段含颈横动脉皮支及胸内动脉第二和/或第三穿支的部位，定期注入生理盐水。设计扩张的锁骨下皮瓣及带胸内动脉穿支的逆行轴型皮瓣，根据皮瓣大小松解或切除颈部瘢痕，转移皮瓣覆盖创面，矫正颈部挛缩畸形。皮瓣面积为9 cm×5 cm～15 cm×7 cm。
所有皮瓣均成活。随访6～30个月，颈部功能及外形均明显改善。但有1例出现胸内动脉穿支逆行支静脉回流障碍，经治疗后血液循环改善。
锁骨下轴型扩张皮瓣联合胸内动脉穿支逆行轴型皮瓣可用于修复颈部瘢痕挛缩畸形，能减少瘢痕，降低再次挛缩的机会。
