Qu Zhi-gang, Liu Yu-jie, He Xu, Ding Xiao-hen, Fang Guan-grong
Hand Surgery Center of PLA, 401th Hospital of PLA, Qingdao 266071, China.
Chin J Traumatol. 2012;15(6):352-4.
To report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu-taneous flaps.
Six patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cm multiply 6 cm to 30 cm multiply 18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissimus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery.
All flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft (3 cases, mostly from the anterior thigh) or was closed primarily (3 cases) and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the function of limb was excellent.
Our experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for reconstruction of large skin and soft tissue defects in the upper extremity.
报告采用带蒂背阔肌肌皮瓣修复上肢大面积皮肤软组织缺损的技术。
本报告纳入6例上肢大面积皮肤软组织缺损患者。其中5例为创伤患者，另1例因上肢瘢痕需行整形手术。所有伤口均在上肢。缺损面积为15cm×6cm至30cm×18cm。根据缺损面积设计带蒂背阔肌肌皮瓣，并连带部分背阔肌一并掀起。术中仔细保护胸背动脉及其穿支。
所有皮瓣均一期愈合，未出现皮瓣充血、边缘坏死或感染。供皮区3例行中厚皮片移植（大多取自大腿前侧），3例直接缝合，术后并发症轻微。6至12个月的随访结果显示，皮瓣外形美观，上肢功能良好。
我们的经验表明，带蒂背阔肌肌皮瓣有利于修复上肢大面积皮肤软组织缺损。
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