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背阔肌皮瓣在头皮重建和术后溃疡管理中的应用。

Latissimus Dorsi Muscle Flap for Scalp Reconstruction and Postoperative Ulceration Management.

机构信息

Department of Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

J Craniofac Surg. 2022 May 1;33(3):e233-e236. doi: 10.1097/SCS.0000000000007997. Epub 2021 Jul 22.

Abstract

The latissimus dorsi muscle (LDM) flap has been widely accepted as the best choice for subtotal or total scalp reconstruction. Because of the unique anatomic and functional features of scalp, ulcerations formation would occur after reconstructive surgeries. in this study, we are presenting a patient with a large scalp defect successfully reconstructed by a latissimus dorsi muscle free flap. Ulcerations with skull exposure formed on the transplanted flap after the first surgery. They were subsequently repaired by flap recycling and tissue expansion techniques. An excellent reconstructive outcome was achieved at the 30-month follow-up after the last surgery and no further complication was found. This clinical report highlights the possibility of ulcer formation after scalp reconstructive surgeries and supports the use of recycle flaps and tissue expanders to manage postoperative ulcerations after latissimus dorsi muscle free flap transplantation.

摘要

阔背肌(LDM)皮瓣已被广泛接受为头皮次全切除或全切除重建的最佳选择。由于头皮的独特解剖和功能特点,重建手术后会发生溃疡形成。在本研究中,我们成功地为一位大面积头皮缺损患者进行了阔背肌游离皮瓣重建。第一次手术后,移植皮瓣上出现了伴有颅骨暴露的溃疡。随后,采用皮瓣再利用和组织扩张技术进行了修复。最后一次手术后 30 个月随访时,获得了极好的重建效果,且未发现进一步的并发症。本临床报告强调了头皮重建手术后溃疡形成的可能性,并支持使用再利用皮瓣和组织扩张器来处理阔背肌游离皮瓣移植后的术后溃疡。

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