Bey Eric, Hautier Aurélie, Pradier Jean-Philippe, Duhamel Patrick
Plastic and Reconstructive Surgery Department, Military Hospital Percy, 101 Avenue Henri Barbusse, Clamart, France.
Burns. 2009 Feb;35(1):123-9. doi: 10.1016/j.burns.2008.03.015. Epub 2008 Jul 7.
After extensive use for head and neck reconstruction, the deltopectoral flap has been supplanted by alternative methods of reconstruction and relegated to historical references. However, it remains a very valuable skin flap and should keep its place in the armamentarium of reconstructive surgeons for postburn head and neck reconstruction. We report here five cases of head and neck reconstruction using the deltopectoral flap: one case of perioral reconstruction after ballistic trauma, one case of nasal reconstruction after burn and three cases of neck reconstruction after burn contracture. Technical simplicity and reliability are the main features of this flap. The skin paddle is thin and pliable, and its surface can be extended after a flap delay. Previous tissue expansion can minimize donor site morbidity. The flap division necessitates a second surgical procedure. The major burn contractures of the neck are, in our opinion, an excellent indication of the deltopectoral flap.
在广泛用于头颈部重建后,三角肌胸大肌皮瓣已被其他重建方法所取代,仅见于历史文献记载。然而,它仍然是一种非常有价值的皮瓣,在重建外科医生用于烧伤后头颈部重建的手段中应占有一席之地。我们在此报告5例使用三角肌胸大肌皮瓣进行头颈部重建的病例:1例弹道伤后口周重建、1例烧伤后鼻重建以及3例烧伤后挛缩性颈部重建。该皮瓣的主要特点是技术操作简单且可靠。皮瓣薄且柔韧,经皮瓣延迟术后其面积可扩大。先前进行组织扩张可将供区并发症降至最低。皮瓣分割需要进行二次手术。我们认为,颈部严重烧伤挛缩是三角肌胸大肌皮瓣的绝佳适应证。