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应用枕颈背增压“超薄皮瓣”修复颈面部瘢痕挛缩:越南82例回顾性分析

Reconstruction of neck and face scar contractures using occipito-cervico-dorsal supercharged "super-thin flaps": A retrospective analysis of 82 cases in Vietnam.

作者信息

Vinh Vu Quang, Van Anh Tran, Gia Tiên Nguyen, Hyakusoku Hiko, Ogawa Rei

机构信息

Department of Plastic and Reconstructive Surgery, Vietnam National Institute of Burns, Thanh-Tri, Hanoi, Viet Nam.

Department of Plastic and Reconstructive Surgery, Vietnam National Institute of Burns, Thanh-Tri, Hanoi, Viet Nam.

出版信息

Burns. 2018 Mar;44(2):462-467. doi: 10.1016/j.burns.2017.07.020. Epub 2017 Aug 31.

DOI:10.1016/j.burns.2017.07.020
PMID:28865836
Abstract

BACKGROUND

The concept of the "super-thin flap" (also known as the subdermal vascular network flap) was introduced in Japan in 1994. Its distinctive characteristic is its extreme thinness: it is thinned to the point that the subdermal vascular network (subdermal plexus) can be seen through the minimal fat layer. Since 2006 in Vietnam, we have used circumflex scapular artery-supercharged occipito-cervico-dorsal (OCD) super-thin flaps to reconstruct cases of neck and face scar contracture.

MATERIALS AND METHODS

This case series comprised all 82 patients with neck and face scar contracture who underwent reconstruction with an OCD supercharged super-thin flap from 2006-2015 at the Vietnam National Institute of Burns. The flap was thinned and anastomosed at the distal area after elevation. All patients received one flap.

RESULTS

Of the 82 flaps, 77 survived completely. The remaining five developed distal superficial necrosis (n=3) and interruption of the sutures due to infection; these required resuturing (n=2). In two of the three necrosis cases, the necrotic area affected 50% of the flap. Eighty of the eighty-two patients were satisfied with both the functional and aesthetic results.

CONCLUSIONS

The OCD super-thin flap has clear benefits, and although it is thin, its vasculature is reliable. Thus, it may be one of the best choices for reconstruction of neck and face scar contractures.

摘要

背景

“超薄皮瓣”(也称为皮下血管网皮瓣)的概念于1994年在日本被提出。其独特之处在于极度轻薄:薄至透过极少量脂肪层就能看到皮下血管网(皮下丛)。自2006年起在越南,我们采用旋肩胛动脉增压枕颈背(OCD)超薄皮瓣来修复颈部和面部瘢痕挛缩病例。

材料与方法

本病例系列包括2006年至2015年期间在越南国家烧伤研究所接受OCD增压超薄皮瓣修复的所有82例颈部和面部瘢痕挛缩患者。皮瓣掀起后在远端区域进行修薄并吻合。所有患者均接受一块皮瓣。

结果

82块皮瓣中,77块完全存活。其余5块出现远端浅表坏死(3例)以及因感染导致缝线断裂;这些需要再次缝合(2例)。在3例坏死病例中的2例,坏死面积累及皮瓣的50%。82例患者中有80例对功能和美学效果均满意。

结论

OCD超薄皮瓣有明显优势,尽管它很薄,但其血供可靠。因此,它可能是修复颈部和面部瘢痕挛缩的最佳选择之一。

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