Takeuchi Masaki, Sakurai Hiroyuki
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba.
J Plast Surg Hand Surg. 2013 Sep;47(4):328-30. doi: 10.3109/2000656X.2012.718893. Epub 2013 Jul 15.
We used internal mammary artery perforator (IMAP) flaps from the opposite side for reconstruction of small-to-medium-sized defects in the chest wall. The IMAP flaps were used in two patients who had unhealed, localised ulcers of the chest wall with exposure of the ribs after radical mastectomy. The lesion was excised widely, and the flap, based on a perforator vessel in the second or third intercostal space of the opposite chest wall, was raised. The flap was rotated from 90° to 180° along the vascular axis to the chest wall defect. The donor site was closed primarily. Both flaps showed stable postoperative circulation and survived completely. Defects of the chest wall could be covered with healthy, well-vascularised tissue on one perforator without deep infection. The IMAP flap is a reliable and less invasive option to be considered for medial, localised, reconstruction of the chest wall.
我们使用对侧的胸廓内动脉穿支（IMAP）皮瓣来修复胸壁中小面积缺损。两名患者在根治性乳房切除术后出现胸壁局部未愈合溃疡且肋骨外露，遂使用IMAP皮瓣。广泛切除病变组织，以对侧胸壁第二或第三肋间穿支血管为蒂掀起皮瓣。皮瓣沿血管轴旋转90°至180°后转移至胸壁缺损处。供区直接缝合。两个皮瓣术后血运均稳定，完全存活。胸壁缺损可由一块穿支皮瓣覆盖健康、血运良好的组织，且无深部感染。IMAP皮瓣是胸壁内侧局限性修复的一种可靠且侵入性较小的选择。
