Department of Plastic Surgery, Peking University Third Hospital, Beijing, China.
J Cosmet Dermatol. 2022 Jul;21(7):2916-2923. doi: 10.1111/jocd.14545. Epub 2021 Oct 30.
Wound healing problem is one of the main complications after correction of chest wall deformity. Orthopedic flap tissue repair technique has a clear significance in non-healing wound and defect wound and provides a new choice for poor wound healing after orthopedic surgery of chest wall deformity.
To investigate, the application value of modified local rotary flap and latissimus dorsi myocutcutaneous flap in the treatment of poor wound healing after orthodontic treatment of chest wall deformity.
A retrospective analysis was performed on patients who admitted to our department from August 2012 to November 2019 due to non-healing incision after surgery for thoracic deformity. Skin flap was selected according to the size of the wound surface, and the effect of skin flap repair was observed. The clinical data of the included patients were recorded, and the preoperative and postoperative wound conditions were evaluated.
This study included 13 patients with chest wall deformity who received plastic surgery tissue using flap technique for wound repair, 11 cases used modified local rotation skin flap, and 2 cases used modified latissimus dorsi myocutaneous flap. The mean age of the 13 patients was 18.54 ± 4.14 years old, the mean body mass index (BMI) was 17.02 ± 2.16 kg/m , and the mean preoperative nonunion time of the incision was 64.77 ± 93.01 days. Five patients had positive bacteria culture on the wound surface, including 3 cases of Staphylococcus aureus, 1 case of Pseudomonas aeruginosa, and 1 case of Staphylococcus epidermidis. All the 13 patients achieved primary grade A healing.
The modified local rotary flap and latissimus dorsi musculocutaneous flap have a significant effect on the postoperative correction of chest wall deformity, which can ensure wound healing while retaining the orthopedic plate to the maximum extent to ensure the effect of the correction.
创面愈合问题是胸廓畸形矫正术后的主要并发症之一。皮瓣组织修复技术在非愈合创面和缺损创面中有明确的意义，为胸廓畸形矫形术后创面愈合不良提供了新的选择。
探讨改良局部旋转皮瓣与背阔肌肌皮瓣在胸廓畸形矫形术后创面愈合不良中的应用价值。
回顾性分析 2012 年 8 月至 2019 年 11 月因胸廓畸形术后切口不愈合来我院就诊的患者，根据创面大小选择皮瓣，观察皮瓣修复效果，记录纳入患者的临床资料，评价术前、术后创面情况。
本研究共纳入 13 例胸廓畸形患者，采用皮瓣技术进行创面修复的整形手术，其中 11 例采用改良局部旋转皮瓣，2 例采用改良背阔肌肌皮瓣。13 例患者的平均年龄为 18.54±4.14 岁，平均体质指数（BMI）为 17.02±2.16 kg/m²，切口术前非愈合时间平均为 64.77±93.01 天。5 例患者创面表面有阳性细菌培养，包括金黄色葡萄球菌 3 例，铜绿假单胞菌 1 例，表皮葡萄球菌 1 例。13 例患者均达到甲级愈合。
改良局部旋转皮瓣与背阔肌肌皮瓣对胸廓畸形矫正术后的效果有明显的改善作用，在保证创面愈合的同时最大限度保留矫形钢板，保证矫正效果。
