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使用带蒂颞浅动脉含毛发皮瓣修复男性上唇严重烧伤挛缩:两例报告

Reconstruction of severe burn contractures of the upper lip in males using a pedicled superficial temporal artery hair-bearing flap. Two case reports.

作者信息

Al-Qattan Mohammad M, AlMutairi Musa H

机构信息

Department of Surgery, King Saud University, P.O. Box 18097, Riyadh, 11415, Saudi Arabia.

Department of Plastic Surgery at Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2020;72:309-312. doi: 10.1016/j.ijscr.2020.06.012. Epub 2020 Jun 12.

Abstract

INTRODUCTION

Severe burn contractures of the upper lip are usually treated either with full thickness skin grafts or flaps. Most authors recommend the free radial forearm flap as the flap of choice. In males, another free flap option is the use of the superficial temporal artery hair-bearing free flap.

CASE REPORTS

In this report, we demonstrate that the superficial temporal artery hair-bearing flap may be used as a pedicle flap (rather than a free flap) for the reconstruction of severe upper lip burn contractures in males. We show our method of flap delay and design to ensure that the distal part of the flap will survive; and this will be demonstrated in two case reports.

DISCUSSION

The pedicled superficial temporal artery flap is much simpler to execute than free flaps.

CONCLUSIONS

Severe post burn contractures of the upper lip in males may be reconstructed using the pedicled superficial temporal artery hair-bearing flap. In order for the flap to reach the contralateral side of the lip, it will have to cross the midline in the scalp. We demonstrate our method of flap delay and design to ensure flap safety and viability. We also show that concurrent burn deformities in close proximity of the upper lip should be treated prior to upper lip reconstruction. Finally, we stress on the principle of reconstructing the entire skin of the upper lip as one aesthetic unit.

摘要

引言

上唇严重烧伤挛缩通常采用全厚皮片移植或皮瓣治疗。大多数作者推荐游离桡动脉前臂皮瓣作为首选皮瓣。对于男性患者,另一种游离皮瓣选择是使用颞浅动脉带毛发游离皮瓣。

病例报告

在本报告中,我们证明颞浅动脉带毛发皮瓣可作为带蒂皮瓣(而非游离皮瓣)用于男性上唇严重烧伤挛缩的重建。我们展示了皮瓣延迟和设计的方法,以确保皮瓣远端存活;这将在两个病例报告中呈现。

讨论

带蒂颞浅动脉皮瓣的操作比游离皮瓣简单得多。

结论

男性上唇严重烧伤后挛缩可使用带蒂颞浅动脉带毛发皮瓣进行重建。为使皮瓣到达对侧唇部,它必须在头皮中越过中线。我们展示了皮瓣延迟和设计的方法,以确保皮瓣安全和存活。我们还表明,上唇附近的并发烧伤畸形应在上唇重建之前进行治疗。最后,我们强调将上唇整个皮肤作为一个美学单元进行重建的原则。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4817/7305348/40e9ab09906e/gr1.jpg

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