摘要
目的探讨巨大胸壁缺损的修复方法。方法2005年10月至2009年6月，为6例患者进行巨大胸壁缺损的修复，其中背阔肌肌皮瓣加钛网1例，逆行背阔肌肌皮瓣加聚丙烯网片和涤纶补片1例，游离股前外侧皮瓣1例，双侧胸大肌肌瓣1例，纵行腹直肌肌皮瓣2例。结果随访1～24个月，皮瓣100％覆盖创面、皮瓣100％成活、心肺功能没有影响、外观满意；并发症：胸壁瘘管1例，胸壁窦道1例经再次清创愈合。结论巨大胸壁缺损需要分层修复，胸廓缺损可以用敛网或聚丙烯网片修补，软组织缺损根据部位、大小和范围及周围组织情况，选择不同的修复方法。背阔肌肌皮瓣组织量大、旋转弧度大、血供恒定、容易切取，可作为首选，胸大肌肌瓣、纵行腹直肌肌皮瓣或游离的股前外侧皮瓣，根据实际情况灵活掌握。
Objective To introduce the management of large chest wail defect. Methods From Oct. 2005 to Jun. 2009, 6 patients with large chest wall defects were reconstructed by latissimus dorsi muscle flap and titanium mesh in one case, reverse latissimus dorsi muscle flap and polypropylene mesh in one case, free lateral anterior thigh flap in one case, bilateral pectoralis muscle flap in one case, and vertical rectum abdominal muscle flaps in two cases. Results The patients were followed up for 1-24 months with good cosmetic and functional results. The flaps survived completely. One case of chest wall fistula and one case of sinus occurred, which healed after debridement. Conclusions Every layers of chest wall defects should be reconstructed, respectively. The chest wall defects should be reconstructed by titanium mesh and polypropylene mesh first. The soft tissue defect should be covered with different flaps according to the location, area and the degree of the defects. Latissimus dorsi muscle flap can be as the first-line treatment with the advantages of good blood supply, flexible movement and abundant tissue volume.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2010年第5期357-359,共3页
Chinese Journal of Plastic Surgery
关键词
外科皮瓣
胸壁
修复外科手术
Surgical flaps
Thoracic wall
Reconstructive surgical procedures
