Zhang Miaomiao, Zhao Yu, Wang Chunlan, Sun Wei
Department of Plastic Surgery, First Affiliated Hospital of Anhui Medical University, Hefei Anhui, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Feb;26(2):223-6.
To investigate the method and effectiveness of expanded delto-pectoral and abdominal perforator flaps in repairing large defects of the face and upper limb after scar excision.
Between August 2000 and February 2011, 25 patients with large scars on face and upper limb were treated. There were 14 males and 11 females with an average age of 27 years (range, 7-36 years). Scars causes were burn and scald in 25 cases with a disease duration of 6 months to 7 years (mean, 4.5 years). The hypertrophic scars located at face in 15 cases, and at upper limb and hand in 10 cases. The soft tissue expanders (300-500 mL in volume) were implanted in the delto-pectoral zone and abdominal region in one-stage operation. In two-stage operation, after scars were resected, defects (9 cm x 7 cm to 17 cm x 8 cm) were repaired with the delto-pectoral perforator flaps (17 cm x 7 cm to 20 cm x 8 cm) in 15 facial scar cases and with the deep inferior epigastric artery perforator flaps (10 cm x 9 cm to 25 cm x 14 cm) in 10 upper limb and hand scar cases. The donor sites were sutured directly.
Partial necrosis of the flaps occurred in 2 cases after operation, then the flap survived after expectant treatment. The other flaps and skin grafts survived successfully, and the incisions healed by first intention. Ten patients were followed up 6 months to 4 years. The appearance, texture, and color of the flaps were similar to those at the donor site.
It is an effective method to use the delto-pectoral perforator flap and the deep inferior epigastric artery perforator flap for repairing soft tissue defects of the face and upper limb after scar excision.
探讨扩张的三角胸肌皮瓣和腹壁穿支皮瓣修复瘢痕切除术后面部及上肢大面积缺损的方法及疗效。
2000年8月至2011年2月，对25例面部及上肢有大面积瘢痕的患者进行治疗。其中男性14例，女性11例，平均年龄27岁（7～36岁）。25例瘢痕均由烧伤和烫伤所致，病程6个月至7年（平均4.5年）。其中15例肥厚性瘢痕位于面部，10例位于上肢及手部。一期手术在三角胸肌区和腹部植入体积为300～500 mL的软组织扩张器。二期手术，切除瘢痕后，15例面部瘢痕患者用三角胸肌穿支皮瓣（17 cm×7 cm至20 cm×8 cm）修复缺损（9 cm×7 cm至17 cm×8 cm），10例上肢及手部瘢痕患者用腹壁下动脉穿支皮瓣（10 cm×9 cm至25 cm×14 cm）修复。供区直接缝合。
术后2例皮瓣出现部分坏死，经保守治疗后皮瓣存活。其余皮瓣及植皮均顺利存活，切口一期愈合。10例患者随访6个月至4年。皮瓣的外观、质地和颜色与供区相似。
应用三角胸肌穿支皮瓣和腹壁下动脉穿支皮瓣修复瘢痕切除术后面部及上肢软组织缺损是一种有效的方法。
