Loghmani Shahriar, Eidy Mohammad, Mohammadzadeh Mahdi, Loghmani Alireza, Raigan Fahimeh
Isfahan University of Medical Sciences, Isfahan, IR Iran.
Iran Red Crescent Med J. 2013 Apr;15(4):292-7. doi: 10.5812/ircmj.1600. Epub 2013 Apr 5.
The thin and pliable skin of the neck is a region with multidirectional activity, and postburn scar contractures tend to form there easily. The supraclavicular flap is used to correct neck scar contractures. Its main vascular supply is the supraclavicular artery, and it can be harvested as either a skin pedicle flap or an island flap (vascular pedicle flap).
In this article, a total of 41 flaps are studied retrospectively and their efficacy in reconstruction of post-burn neck scar contractures is discussed. Also donor-site morbidity, patient satisfaction, and complications were evaluated.
Between November of 2004 and January of 2009, 41 supraclavicular flaps were used for reconstructions in 32 patients at the authors' hospital. Twenty-four of these flaps were skin pedicle flaps, and 17 were island flaps. The range of flap size was 18 ± 6 cm in length, and 9 ± 3 cm in width. Pre-expansion was performed in 14 flaps. Primary closure of donor site was performed in 35 flaps.
Thirty-seven of the 41 flaps survived completely, but there were three cases of distal necrosis (10-30%), and one case of complete flap necrosis. Twenty-nine of the 32 patients were satisfied with both the functional and aesthetic results.
Scarring of the neck produces problems with function, and appearance. In our view, the supraclavicular flap, a thin flap of good texture, is an excellent and highly reliable flap for covering defects of the anterior neck. This flap is easy to harvest, with good functional and aesthetic results.
颈部皮肤薄且柔韧，是一个多方向活动的区域，烧伤后瘢痕挛缩容易在此处形成。锁骨上皮瓣用于矫正颈部瘢痕挛缩。其主要血供为锁骨上动脉，可作为带蒂皮瓣或岛状皮瓣（血管蒂皮瓣）切取。
本文回顾性研究了41例皮瓣，并探讨了其在烧伤后颈部瘢痕挛缩重建中的疗效。同时评估了供区并发症、患者满意度及并发症情况。
2004年11月至2009年1月，作者所在医院32例患者采用41例锁骨上皮瓣进行重建。其中24例为带蒂皮瓣，17例为岛状皮瓣。皮瓣大小范围为长18±6cm，宽9±3cm。14例皮瓣进行了预扩张。35例皮瓣供区直接缝合。
41例皮瓣中37例完全存活，但有3例出现远端坏死（10% - 30%），1例皮瓣完全坏死。32例患者中29例对功能和美观效果均满意。
颈部瘢痕会导致功能和外观问题。我们认为，锁骨上皮瓣质地薄，是覆盖颈部前部缺损的优良且高度可靠的皮瓣。该皮瓣切取容易，功能和美观效果良好。
