Ning Fanggang, Qin Fengjun, Chen Xin, Zhang Guoan
Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China.
Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China; Email:
Zhonghua Shao Shang Za Zhi. 2015 Dec;31(6):421-3.
To explore the clinical effects of ipsilateral lower trapezius myocutaneous flap for repairing cervical ulcer as a result of radiotherapy after radical mastectomy.
Six patients with cervical ulcers as a result of radiotherapy after radical mastectomy were hospitalized from March 2010 to February 2015, suffering from persistent pain in different degrees. The wound area ranged from 6 cm × 4 cm to 10 cm × 6 cm before debridement, 8 cm × 5 cm to 16 cm × 10 cm after debridement. Ipsilateral lower trapezius myocutaneous flap was used to repair the wound after thorough debridement, with the area ranging from 10 cm × 7 cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with medium-thickness skin graft obtained from the back.
Pain was obviously relieved in all the patients 2 days after surgery. The wounds in five patients were healed, while necrosis of superficial skin approximately 1 cm in diameter appeared at the distal end of one myocutaneous flap, and it healed after dressing change. During the follow-up period of 3 to 18 months, no recurrence of ulcer was found, the texture of the myocutaneous flaps was soft with good appearance, and the donor sites healed well.
On the basis of thorough debridement, it is feasible to repair the cervical ulcer as a result of radiotherapy after radical mastectomy with the ipsilateral lower trapezius myocutaneous flap.
探讨采用同侧下斜方肌肌皮瓣修复乳腺癌根治术后放疗所致颈部溃疡的临床效果。
选取2010年3月至2015年2月收治的6例乳腺癌根治术后放疗所致颈部溃疡患者，均有不同程度的持续性疼痛。清创前创面面积为6 cm×4 cm至10 cm×6 cm，清创后为8 cm×5 cm至16 cm×10 cm。彻底清创后采用同侧下斜方肌肌皮瓣修复创面，肌皮瓣面积为10 cm×7 cm至20 cm×13 cm。供区直接缝合或用取自背部的中厚皮片覆盖。
术后2天所有患者疼痛均明显缓解。5例患者创面愈合，1例肌皮瓣远端出现直径约1 cm的表浅皮肤坏死，经换药后愈合。随访3至18个月，未见溃疡复发，肌皮瓣质地柔软，外观良好，供区愈合良好。
在彻底清创的基础上，采用同侧下斜方肌肌皮瓣修复乳腺癌根治术后放疗所致颈部溃疡是可行的。
