Bruant-Rodier C, Ruffenach L, Hendriks S, Bodin F, Dissaux C
Service de chirurgie plastique reconstructrice et esthétique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
Service de chirurgie plastique reconstructrice et esthétique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
Ann Chir Plast Esthet. 2018 Nov;63(5-6):405-421. doi: 10.1016/j.anplas.2018.06.014. Epub 2018 Sep 1.
Despite the development of microsurgical techniques, latissimus dorsi myocutaneous pedicle flap remains mainly used in breast reconstruction surgery. It is reliable and could be performed on almost all the patients, even if they smoke. It is also a good indication in case of irradiation. The technical alternative, which combines latissimus dorsi myocutaneous flap and an implant, allows the reconstruction of the expected volume and enables controlateral implant augmentation if the patient desires. The dorsal skin paddle increases the cutaneous pocket. The muscle in-depth enhances the irradiated skin and protects the implant. Positioning the skin paddle on the breast area is essential: it should be based on the mastectomy scar or on an added contraincision barring it. Thus it allows the muscle to embrace the implant as a bra. The precise reference points helping the placement of the flap could be reproduced and ensure pleasant and stable results over time.
尽管显微外科技术有所发展，但背阔肌肌皮蒂瓣仍主要用于乳房重建手术。它可靠，几乎所有患者都可进行，即使患者吸烟也不影响。在放疗情况下也是一个很好的选择。将背阔肌肌皮瓣与植入物相结合的技术替代方案，可重建预期体积，并且如果患者有需求，还能进行对侧植入物增大术。背部皮瓣可增加皮肤腔隙。肌层深入可增强受照射皮肤并保护植入物。将皮瓣置于乳房区域至关重要：应基于乳房切除术瘢痕或额外增加的辅助切口来确定位置。这样可使肌肉像胸罩一样包裹植入物。有助于皮瓣放置的精确参考点可重现，且能确保随着时间推移获得美观且稳定的效果。
