Liang Gang, Li Jian, Ding Jian, Zhang Zhi-xin, Sun Jian-ping
Department of Plastic and Burns Surgery, the Second Hospital of Shaoxing City, Shaoxing 312000, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2010 Nov;26(6):426-30.
To investigate the feasibility and therapeutic effect of lateral thoracic flaps pedicled with subscapular vessels for defects in the upper extremities.
From June 2003 to September 2009, 5 cases with large soft tissue defects in the upper extremities were treated with lateral thoracic flaps pedicled with subscapular vessels. The flap size ranged from 23 cm x 8 cm to 40 cm x 20 cm. The subscapular vessels, the thoracodorsal vessels, the lateral branch and the cutaneous perforators of thoracodorsal vessels were all included in the flap. A muscular sleeve of 2-3 cm in width was preserved to protect the musculocutaneous perforator. The defects in the donor area were closed directly or covered by skin graft.
The lateral thoracic flaps were used in four cases. A combination of lateral thoracic flap and paraumbilical flap was used in one case. Partial necrosis happened at the distal portion of the flap in one case. All the other flaps survived completely. 4 cases were followed up for two to fourteen months with satisfactory cosmetic and functional results. The color, texture and thickness of the flaps were also satisfactory.
The lateral thoracic flap pedicled with the subscapular vessel is flexible for repairing defects in the upper extremities with a reliable blood supply, leaving less morbidity to donor site.
探讨以肩胛下血管为蒂的胸外侧皮瓣修复上肢缺损的可行性及治疗效果。
2003年6月至2009年9月，采用以肩胛下血管为蒂的胸外侧皮瓣修复5例上肢大面积软组织缺损。皮瓣大小为23 cm×8 cm至40 cm×20 cm。皮瓣包含肩胛下血管、胸背血管、胸背血管外侧支及皮穿支。保留2～3 cm宽的肌袖以保护肌皮穿支。供区缺损直接缝合或植皮覆盖。
4例采用胸外侧皮瓣，1例采用胸外侧皮瓣联合脐旁皮瓣。1例皮瓣远端部分坏死，其余皮瓣全部成活。4例随访2～14个月，外形和功能效果满意，皮瓣颜色、质地及厚度均良好。
以肩胛下血管为蒂的胸外侧皮瓣修复上肢缺损具有灵活性，血供可靠，供区损伤小。
