Ma Xianjie, Li Yang, Li Weiyang, Liu Chaohua, Liu Hengxin, Xue Ping, Cui Jiangbo
Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
J Craniofac Surg. 2017 Sep;28(6):1554-1558. doi: 10.1097/SCS.0000000000003901.
The facial-cervical scars bring the suffering to the patients both physically and mentally. Choosing a proper donor soft tissue is always one of the critical issues, especially to Asian patients. Among the common used donor sites, the deltopectoral site was conceived as the most suitable donor tissue for the reconstruction in face and neck for its adjacent site and match in color and texture. There were 220 patients with facial-cervical scars reconstructed by the pedicled expanded deltopectoral flap between 2007 through 2015 in the authors' hospital. There are 4 stages, including tissue expansion, flap pedicled transfer, pedicle delaying, and pedicle division, for the reconstruction of the facial-cervical scars using the pedicled expanded deltopectoral flap. Good skin compliance, normal contours, and emotional expression were noted in all the patients after the reconstruction. However, there were complications including expander exposure, stretch marks, flap tip necrosis, and mild postoperative hypertrophic scars. The unpleasant skin wound or color caused by the complications was repaired by further treatments such as skin grafting and laser. In conclusion, the pedicled expanded deltopectoral flap is a reliable and excellent option for the reconstruction of the facial-cervical scars.
面颈部瘢痕给患者带来身体和心理上的痛苦。选择合适的供区软组织一直是关键问题之一，对亚洲患者而言尤其如此。在常用的供区中，胸三角区因其位置相邻且颜色和质地匹配，被认为是面部和颈部重建最合适的供区组织。2007年至2015年期间，作者所在医院有220例面颈部瘢痕患者采用带蒂扩张胸三角皮瓣进行重建。采用带蒂扩张胸三角皮瓣重建面颈部瘢痕有4个阶段，包括组织扩张、皮瓣带蒂转移、蒂延迟和蒂切断。所有患者重建后均具有良好的皮肤顺应性、正常外形和表情。然而，出现了包括扩张器外露、瘢痕、皮瓣尖端坏死和术后轻度增生性瘢痕等并发症。并发症导致的皮肤伤口不佳或颜色问题通过植皮和激光等进一步治疗进行修复。总之，带蒂扩张胸三角皮瓣是面颈部瘢痕重建的可靠且优秀的选择。
