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用于修复头颈部烧伤后远隔部位瘢痕的带肌下隧道的锁骨下动脉岛状皮瓣的技术改进

Technical Refinements of Supraclavicular Artery Island Flap With Submuscular Tunnel for Reconstruction of Remote Head and Neck Postburn Scars.

作者信息

Ellabban Mohamed A, Steinvall Ingrid, Sjöberg Folke, Elmasry Moustafa

机构信息

From the Department of Hand Surgery, Plastic Surgery and Burns and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Plastic and Reconstructive Surgery Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Plast Reconstr Surg Glob Open. 2025 Feb 14;13(2):e6455. doi: 10.1097/GOX.0000000000006455. eCollection 2025 Feb.

DOI:10.1097/GOX.0000000000006455
PMID:39958716
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11828006/
Abstract

BACKGROUND

The supraclavicular artery island flap (SCAIF) has been used extensively to reconstruct postburn scars in the head and neck region. Its landmark and vascular supply from the supraclavicular artery have been demonstrated before. The aim was to assess its versatility following an increase in pedicle length to be supplied by the transverse cervical artery, along with tunneling the pedicle under the sternocleidomastoid muscle to reach distant sites that the classic SCAIF could not reach.

METHODS

A retrospective analysis was conducted of 25 consecutive patients in whom SCAIFs were performed to reconstruct remote head and neck postburn scars. Pedicle length, flap diameter, and complications were recorded with demographic and burn-related data.

RESULTS

The study included 18 (72%) men and 7 (18%) women. The mean age was 15.7 years, and the mean injury time was 15 months before flap transfer. Isolated neck injury was the most affected site (44%). The mean length and width of the SCAIF were 16.6 and 6.5 cm, respectively. The mean length of its extended vascular pedicle based on transverse cervical artery was 7.2 cm. The donor site was closed primarily in all cases. All flaps survived completely, except 2 (8%) that exhibited partial necrosis.

CONCLUSIONS

The SCAIF is reliable for reconstructing postburn deformities in the head and neck region. Our results indicate that the increased pedicle length and the submuscular tunnel allow reliable distant flap transfer without the risk of excessive traction or vessel kinking.

摘要

背景

锁骨上动脉岛状皮瓣（SCAIF）已被广泛用于修复头颈部烧伤后瘢痕。此前已证实其标志性特征及来自锁骨上动脉的血供。目的是评估在增加由颈横动脉供血的蒂长度，并将蒂在胸锁乳突肌下隧道化以到达经典SCAIF无法到达的远处部位后，该皮瓣的多功能性。

方法

对连续25例行SCAIF修复头颈部远处烧伤后瘢痕的患者进行回顾性分析。记录皮瓣蒂长度、直径和并发症，以及人口统计学和烧伤相关数据。

结果

该研究纳入18名男性（72%）和7名女性（18%）。平均年龄为15.7岁，皮瓣转移前平均受伤时间为15个月。单纯颈部损伤是最常受累部位（44%）。SCAIF的平均长度和宽度分别为16.6 cm和6.5 cm。基于颈横动脉的延长血管蒂平均长度为7.2 cm。所有病例供区均一期缝合。除2例（8%）出现部分坏死外，所有皮瓣均完全存活。

结论

SCAIF用于修复头颈部烧伤后畸形是可靠的。我们的结果表明，增加的蒂长度和肌下隧道可实现可靠的远处皮瓣转移，而无过度牵拉或血管扭结的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/47db7c00e082/gox-13-e6455-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/f951af18929a/gox-13-e6455-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/be543ff54721/gox-13-e6455-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/624e69fd3e9a/gox-13-e6455-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/47db7c00e082/gox-13-e6455-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/f951af18929a/gox-13-e6455-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/be543ff54721/gox-13-e6455-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/624e69fd3e9a/gox-13-e6455-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f2/11828006/47db7c00e082/gox-13-e6455-g004.jpg

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本文引用的文献

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Curr Opin Otolaryngol Head Neck Surg. 2017 Oct;25(5):439-444. doi: 10.1097/MOO.0000000000000385.
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Postburn Head and Neck Reconstruction: An Algorithmic Approach.烧伤后头颈部重建：一种算法化方法。
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The supraclavicular artery flap for head and neck reconstruction.锁骨上动脉皮瓣在头颈部重建中的应用。
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The supraclavicular artery island flap in head and neck reconstruction: applications and limitations.锁骨上动脉岛状瓣在头颈部重建中的应用及局限性。
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A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients.应用锁骨上皮瓣修复晚期癌症患者头颈部缺损的临床经验。
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Oropharyngeal reconstruction using the supraclavicular artery island flap: a new flap alternative.应用锁骨上动脉岛状皮瓣行口咽重建：一种新的皮瓣选择。
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Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation.基于颈横动脉的扩大锁骨上岛状筋膜皮瓣用于癌症切除术后头颈部重建。
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