Kang Ajaipal S, Kang Kevin S
Department of Surgery, UPMC Hamot, Erie, Pa.
Geisel Dartmouth Medical School, Hanover, N.H.
Plast Reconstr Surg Glob Open. 2020 Jun 18;8(6):e2932. doi: 10.1097/GOX.0000000000002932. eCollection 2020 Jun.
Resection of large cutaneous malignancies may result in substantial skin defects. Often, skin grafting is a first-line option for reconstruction of such defects but may be limited by poor cosmetic outcomes and incomplete graft acceptance. Accordingly, skin flaps, tissue rearrangement techniques, and more complex procedures may be needed. This case report presents the successful use of a rhomboid flap for reconstruction of a 20 × 19 cm-sized trunk skin defect left after a squamous cell cancer resection. The flap was quickly and easily fashioned, did not require any special instruments, and resulted in a good cosmetic outcome. There were no major wound complications despite postoperative radiation therapy. At 1-year follow-up, the flap healed completely with excellent contour, texture, thickness, color match, and complete patient satisfaction. In the past, rhomboid flaps have been used for small defects. This case is a unique example of a versatile and successful rhomboid flap reconstruction of an extremely large defect, instead of a more complicated reconstructive option.
大面积皮肤恶性肿瘤切除可能会导致大面积皮肤缺损。通常,皮肤移植是修复此类缺损的一线选择,但可能会受到美容效果不佳和移植皮肤不完全存活的限制。因此,可能需要使用皮瓣、组织重排技术以及更复杂的手术方法。本病例报告展示了成功使用菱形皮瓣修复鳞状细胞癌切除术后留下的20×19厘米大小的躯干皮肤缺损。该皮瓣制作迅速且简便,无需任何特殊器械,并且美容效果良好。尽管术后进行了放射治疗,但未出现重大伤口并发症。在1年的随访中,皮瓣完全愈合,外形、质地、厚度、颜色匹配良好,患者十分满意。过去,菱形皮瓣多用于小面积缺损。本病例是一个独特的范例,展示了使用多功能且成功的菱形皮瓣修复极大面积缺损,而非采用更复杂的重建方案。