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腋窝挛缩的罕见病例:挛缩瘢痕下被困的健康皮肤及其附属器。

An extraordinary case of axillary contracture: trapped healthy skin and its adnexes under contracted scar.

作者信息

Nisanci Mustafa, Sahin Ismail, Guzey Serbulent

机构信息

Department of Plastic and Reconstructive Surgery, Gulhane Military Medical Academy, Ankara, Turkey.

出版信息

Int Surg. 2014 Jul-Aug;99(4):442-6. doi: 10.9738/INTSURG-D-13-00127.1.

Abstract

Although striking improvements have been achieved in overall management of burn injury, postburn contractures are still an ongoing challenge to burn surgeons. Axillary adduction contracture is one of the most common types of these disabling postburn complications that usually result from suboptimal treatment after acute burns. An unusual and complicated case of axillary contracture in which the unburned, healthy axillary dome skin was trapped as a cystic mass under the scarred area was reconstructed by transfer of a big (17×13-cm) thoracodorsal artery perforator flap after contracture release. The result was satisfactory in terms of function and acceptable cosmetically. The underlying reasons for the inadequate treatment the patient received after surviving a severe electrical injury were discussed.

摘要

尽管在烧伤的整体治疗方面已取得显著进展,但烧伤后挛缩仍是烧伤外科医生面临的持续挑战。腋窝内收挛缩是这些致残性烧伤后并发症中最常见的类型之一,通常是急性烧伤后治疗不充分所致。本文报道了1例罕见且复杂的腋窝挛缩病例,挛缩松解后,通过转移一块大的(17×13cm)胸背动脉穿支皮瓣修复,将未烧伤的健康腋窝顶部皮肤作为囊性肿物包裹于瘢痕组织下。术后功能恢复满意,外观可接受。文中讨论了该患者在严重电烧伤存活后治疗不足的潜在原因。

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