Raguse Jan D, Czabanka Marcus, Voss Jan Oliver, Hartwig Stefan, Vajkoczy Peter, Voss Pit, Doll Christian
Department of Oral and Maxillofacial Surgery/Clinical Navigation, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
Department of Neurosurgery, Campus Virchow-Clinic, Charité - Universitätsmedizin Berlin, Germany.
J Craniomaxillofac Surg. 2016 Aug;44(8):969-72. doi: 10.1016/j.jcms.2016.06.005. Epub 2016 Jun 15.
Stable coverage of complicated defects located between the craniocervical and cervicothoracic junction following wound healing disturbance after spinal surgery can be challenging. Especially in cases where devices are exposed, well-vascularized coverage is required to achieve stable wound conditions. Therefore, the aim of the present study was to evaluate the clinical outcome of the lower trapezius island myocutaneous flap (LTIMF) as a possible treatment option.
Four patients with a mean age of 68.8 years (ranging from 50 to 93 years) with wound healing disturbance following spinal surgery leading to defects of the dorsal neck/upper back refractory to conservative treatment and surgical debridement were included. All defects were reconstructed with a LTIMF based on the transverse cervical artery.
Mean follow-up was 16.5 months (ranging from 5 to 30 months). No major flap failure occurred; minor complications in three patients including lateral superficial skin necrosis were easily handled. In all patients, excellent functional and aesthetic results were achieved.
The lower trapezius island myocutaneous flap represents a reliable treatment option to cover complicated defects located between the craniocervical and cervicothoracic junction following wound disturbance after spinal surgery.
脊柱手术后伤口愈合障碍导致颅颈和颈胸交界处之间的复杂缺损实现稳定覆盖具有挑战性。特别是在器械外露的情况下，需要良好的血管化覆盖以实现稳定的伤口状况。因此，本研究的目的是评估下斜方肌岛状肌皮瓣（LTIMF）作为一种可能的治疗选择的临床效果。
纳入4例平均年龄68.8岁（50至93岁）的患者，这些患者脊柱手术后出现伤口愈合障碍，导致颈背/上背部缺损，保守治疗和手术清创均无效。所有缺损均采用基于颈横动脉的下斜方肌岛状肌皮瓣进行重建。
平均随访16.5个月（5至30个月）。未发生重大皮瓣坏死；3例患者出现轻微并发症，包括外侧浅表皮肤坏死，处理起来很容易。所有患者均获得了优异的功能和美学效果。
下斜方肌岛状肌皮瓣是脊柱手术后伤口紊乱后覆盖颅颈和颈胸交界处之间复杂缺损的可靠治疗选择。
