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应用双蒂扩张额部皮瓣修复前颈部瘢痕挛缩的美观与功能。

Aesthetic and functional restoration of anterior neck scar contracture using a bipedicled expanded forehead flap.

机构信息

Peking Union Medical College, Plastic Surgery Hospital of Chinese Academy of Medical Sciences, Beijing 100144, China.

出版信息

Burns. 2011 Dec;37(8):1444-8. doi: 10.1016/j.burns.2011.07.012. Epub 2011 Sep 8.

Abstract

OBJECTIVE

The study aimed to explore a new method to restore functional and cosmetic outcomes for anterior neck burn scar contracture.

METHODS

Tissue expanders were implanted subcutaneously under the muscle of the forehead. Tissue expansion started 1 week postoperatively. When the skin expansion finished, a bilateral pedicled expanded skin flap was created on the basis of the superficial temporal artery and transferred to the anterior neck. Both the range of motion of cervical spine and the mental cervical angle were measured before and after operation. Data were analysed by Statistical Package for Social Sciences (SPSS) 13.0 and t-test.

RESULTS

From September 2006 to May 2010, six male patients were treated by this method. The active range of motion of the neck of patients improved, the postoperative ranges of active flexion, extension, left flexion, right flexion and left and right rotation of cervical spine increased respectively. The mental cervical angle was 152.7±1.9° preoperatively and 90.7±2.2° postoperatively; the physiological angle was recovered. Patients were followed up from 5 months to 3 years, they were satisfied with the results and no recurrence of contracture was found.

CONCLUSION

The bipedicled expanded forehead flap, which provided good blood supply, repaired anterior contracture in the neck and created both aesthetic and functional results; it also diminished donor morbidity.

摘要

目的

本研究旨在探索一种修复颈部前侧烧伤瘢痕挛缩的新方法,以恢复其功能和美观。

方法

在额肌下的皮下植入组织扩张器。术后 1 周开始进行组织扩张。当皮肤扩张完成后,基于颞浅动脉在额部两侧创建带蒂扩张皮瓣,并将其转移到颈部前侧。测量术前和术后颈椎的活动范围以及颈颏角。使用 SPSS 13.0 软件进行数据统计分析,采用 t 检验。

结果

2006 年 9 月至 2010 年 5 月,6 例男性患者接受了这种方法的治疗。患者颈部的活动范围得到了改善,术后颈椎的主动前屈、后伸、左屈、右屈以及左右旋转的活动范围均增加。术前颈颏角为 152.7±1.9°,术后为 90.7±2.2°;恢复了生理角度。患者的随访时间为 5 个月至 3 年,他们对结果满意,且无挛缩复发。

结论

双蒂额部扩张皮瓣提供了良好的血液供应,修复了颈部前侧的挛缩,同时达到了美观和功能的效果,并且减少了供区的并发症。

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