Ulrich Dietmar, Fuchs Paul, Pallua Norbert
Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital Aachen, Aachen, Germany.
J Burn Care Res. 2008 Mar-Apr;29(2):386-9. doi: 10.1097/BCR.0b013e31816677d9.
Preexpanded flaps are a method to replace a larger postburn contracture area. We describe the use of a preexpanded vertical trapezius musculocutaneous flap for reconstruction of a severe mentosternal contracture in a 10-year-old male patient with second- to third-degree burn wounds. A 500 cm(3) rectangular-shaped tissue expander was inserted under the trapezius muscle via a lateral incision in first stage. Two months later, after serial expansion of the expander, the neck scar was excised. The preexpanded flap (size = 27 x 9 cm) was harvested and rotated into the defect. The donor site could be closed primarily. The flap totally survived. The hospital stay was 7 days. After 6 months follow-up, a significant improved range of motion with good esthetic outcome was achieved. The use of a preexpanded trapezius flap can provide thin, large, and pliable tissue for reconstruction of a severe mentosternal scar contracture with excellent functional outcomes.
预扩张皮瓣是一种用于替代较大面积烧伤后挛缩区域的方法。我们描述了在一名患有二度至三度烧伤创面的10岁男性患者中，使用预扩张的垂直斜方肌肌皮瓣重建严重的颏胸挛缩。在第一阶段，通过外侧切口将一个500立方厘米的矩形组织扩张器插入斜方肌下方。两个月后，在对扩张器进行系列扩张后，切除颈部瘢痕。切取预扩张皮瓣（尺寸为27×9厘米）并旋转至缺损处。供区可直接缝合。皮瓣完全存活。住院时间为7天。经过6个月的随访，实现了显著改善的活动范围和良好的美学效果。使用预扩张的斜方肌皮瓣可为严重的颏胸瘢痕挛缩重建提供薄、大且柔韧的组织，功能效果极佳。
