Ji P, Cao T, Zhang Z, Zhang Y, Hu S J, Wang J C, Han C, Wang J, Shi J H, Hu D H, Tao K
Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China.
Department of Burns and Plastic Surgery, Bozhou City People's Hospital, Bozhou 236814, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022 Apr 20;38(4):328-334. doi: 10.3760/cma.j.cn501120-20211231-00426.
To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14 day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. On the 14 day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14 day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.
探讨扩张背阔肌动脉穿支皮瓣游离移植修复烧伤后颈部瘢痕挛缩畸形的临床效果。进行一项回顾性观察研究。2018年5月至2021年4月,空军军医大学第一附属医院收治符合纳入标准的烧伤后颈部瘢痕挛缩畸形患者11例,其中男3例,女8例,年龄5~46岁,颈部瘢痕挛缩畸形病程5个月至8年。颈部瘢痕挛缩畸形程度为Ⅰ度1例,Ⅱ度9例,Ⅲ度1例。第一期,根据颈部瘢痕大小,于背部置入1个额定容量200~600 mL的矩形皮肤软组织扩张器(以下简称扩张器)。扩张时间4~12个月,生理盐水总注入量为扩张器额定容量的3.0~3.5倍。第二期,切取面积为10 cm×7 cm至2
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