Al-Qattan Noha M, Al-Qattan Mohammad M, Pant Rajeev
Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia; Division of Plastic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2017;37:97-101. doi: 10.1016/j.ijscr.2017.06.006. Epub 2017 Jun 13.
Numerous pedicle and free flaps have been used to cover complex defects of the shoulder girdle and posterior neck triangle following tumor resection. We describe our choice of flap selection in these patients with case examples.
Three cases examples demonstrate our choice of flap selection. In the first case, an anterior shoulder girdle defect is covered by an anteriorly transposed latissimus dorsi muscle flap. The second case demonstrates the coverage of a posterior shoulder girdle defect by a posteriorly transposed latissimus dorsi muscle flap. Finally, the third case demonstrates the coverage of a posterior triangle neck defect using a superiorly transposed pectoralis major muscle flap. All reconstructions utilize muscle flaps (covered by split-thickness skin grafts) and not myocutaneous flaps.
We demonstrate that these two pedicle muscle flaps are adequate for coverage of large complex defects of the shoulder girdle and posterior neck triangle. We also demonstrate the advantages of using muscle rather than myocutaneous flaps.
Pedicle latissimus dorsi and pectoralis major muscle flaps are simpler and preferred over free flaps for coverage of complex defects of the shoulder girdle and posterior neck triangle. The use of muscle rather than myocutaneous flaps will reduce the size of the original defect, make flap design easier and reduce donor site morbidity.
在肿瘤切除术后，众多带蒂皮瓣和游离皮瓣已被用于覆盖肩胛带和后颈部三角区的复杂缺损。我们通过病例举例来阐述我们在这些患者中选择皮瓣的方法。
三个病例举例说明了我们对皮瓣选择的方法。在第一个病例中，肩胛带前侧缺损由向前移位的背阔肌肌皮瓣覆盖。第二个病例展示了肩胛带后侧缺损由向后移位的背阔肌肌皮瓣覆盖。最后，第三个病例展示了使用向上移位的胸大肌肌皮瓣覆盖后颈部三角区缺损。所有重建均使用肌皮瓣（覆盖中厚皮片）而非肌皮瓣。
我们证明这两种带蒂肌皮瓣足以覆盖肩胛带和后颈部三角区的大型复杂缺损。我们还证明了使用肌皮瓣而非肌皮瓣的优势。
带蒂背阔肌和胸大肌肌皮瓣比游离皮瓣更简单，更适合用于覆盖肩胛带和后颈部三角区的复杂缺损。使用肌皮瓣而非肌皮瓣将减小原缺损的大小，使皮瓣设计更简便，并减少供区并发症。
