Watanabe Hidetaka, Uemura Tetsuji, Chuman Takahiro, Kawano Hiroshige, Nagano Yoshihiro, Yoshizumi Mariko, Nakagawa Eiji
Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.
J Plast Reconstr Surg. 2024 Feb 16;3(3):115-119. doi: 10.53045/jprs.2023-0020. eCollection 2024 Jul 27.
Complete resection of anterior chest wall keloids and direct closure of wound defects are difficult. Therefore, intrakeloid excision is usually the safest to treat anterior chest wall keloids. Total excision to relieve tension may require tensile suturing of the dermis or skin grafting, which can lead to recurrence or poor cosmetic outcomes. In this study, we performed total resection of the anterior chest wall keloid, followed by defect reconstruction using bilateral lotus petal flaps for the internal mammary artery perforators near the keloid, obtaining satisfactory results. When performing total keloid resection, releasing the precordial tension in the reconstruction area is crucial. The lotus petal flap, which can be elevated from the same precordial chest area, effectively releases tension and thus provides a beneficial treatment strategy.
完全切除前胸壁瘢痕疙瘩并直接闭合伤口缺损很困难。因此，瘢痕疙瘩内切除通常是治疗前胸壁瘢痕疙瘩最安全的方法。为缓解张力而进行的完全切除可能需要真皮层的张力缝合或植皮，这可能导致复发或美容效果不佳。在本研究中，我们对前胸壁瘢痕疙瘩进行了完全切除，然后使用双侧莲花瓣皮瓣对瘢痕疙瘩附近的胸廓内动脉穿支进行缺损重建，取得了满意的效果。在进行瘢痕疙瘩完全切除时，在重建区域释放心前区张力至关重要。莲花瓣皮瓣可从前胸壁同一区域掀起，能有效释放张力，从而提供了一种有益的治疗策略。
