Yanko-Arzi Ravit, Gur Eyal, Margulis Alexander, Bickels Jacob, Dadia Shlomo, Gortzak Yair, Zaretski Arik
Department of Reconstructive and Aesthetic Surgery, Tel Aviv Sourasky Medical Center, Israel.
Department of Plastic Surgery, Hadassah Medical Center, Hadassah Medical Campus-Ein Kerem, Jerusalem, Israel.
J Reconstr Microsurg. 2014 Jun;30(5):305-12. doi: 10.1055/s-0033-1361841. Epub 2014 Jan 7.
Reconstruction of the posterior neck is one of the rarer procedures performed by plastic surgeons; we used free flaps for the closure of defects in this area in six cases over the past 4 years. Six patients were located requiring posterior neck reconstruction between the years 2007 and 2013. Five of these patients required reconstruction due to oncologic resections, while one underwent serial removal of a giant congenital nevus. Five of these reconstructions involved the use of a free anterolateral thigh/vastus lateralis flap, and the sixth received a pre-expanded deep inferior epigastric perforator flap. Satisfactory dorsal neck reconstruction was achieved with the free flap approach: it produced excellent healing, contour and coverage of hardware. There was only one early minor complication, allowing early return to daily activities and continuation of planned oncologic treatment. Free flap reconstruction of the posterior neck area is a safe and relatively rapidly performed procedure that yields good results both functionally and aesthetically. In this article, we review the literature on the options available for reconstruction of the posterior neck, describe our surgical experience in such cases, and suggest an algorithm to guide in choosing the optimal approach for a given patient.
后颈部重建是整形外科医生开展的较为少见的手术之一；在过去4年里，我们应用游离皮瓣修复该区域缺损6例。2007年至2013年间有6例患者需要进行后颈部重建。其中5例患者因肿瘤切除需要重建，1例接受了巨大先天性痣的分期切除。这些重建手术中有5例采用游离股前外侧/股外侧肌皮瓣，第6例采用预扩张的腹壁下深动脉穿支皮瓣。游离皮瓣法实现了满意的颈背部重建：愈合良好，外形佳，内置物覆盖良好。仅发生1例早期轻微并发症，患者可早期恢复日常活动并继续进行计划中的肿瘤治疗。后颈部区域的游离皮瓣重建是一种安全且实施相对迅速的手术，在功能和美学方面均能取得良好效果。在本文中，我们回顾了有关后颈部重建可用方法的文献，描述了我们在此类病例中的手术经验，并提出一种算法以指导为特定患者选择最佳手术方法。
