摘要
目的:总结以腹壁上动脉为蒂的下腹部横形皮瓣行乳房重建和胸部创面修复的临床应用经验。方法:以腹壁上动脉为蒂,腹壁上、下动脉运行区域携带约中1/3部分腹直肌及前鞘的下腹部横形皮瓣共10例,其中应用于乳腺癌根治术后即刻乳房重建5例,修复胸壁放射性溃疡3例,复发性乳腺癌再手术创面一期修复2例。结果:皮瓣16cm×8cm～25cm×14cm,10例皮瓣全部成活,腹部创面均直接拉拢缝合,胸、腹部没有严重并发症发生。随访3个月至3年,皮瓣受区外形满意,腹部无腹壁疝发生及明显腹壁薄弱表现。结论:携带约中部1/3部分腹直肌肌束及前鞘的腹壁上动脉为蒂的下腹部横形皮瓣,有可靠的血供,皮瓣切取面积大,操作简化,能有效地防止腹壁疝和腹壁薄弱的发生,是乳房重建和胸壁创面修复的理想选择。
Objective：To summarize the clinical application experience of breast reconstruction and chest wound repaired with the lower abdomen transverse flap pedicled with superior epigastric artery. Methods： Ten patients were treated with the lower abdomen transverse flap pedicled with superior epigasric artery. The superior and inferior epigastric atery running in region to bring about central 1/3 part of rectus abdominis muscle and former sheath. Among these patients,5 cases were accepted breast reconstruction immediately after the radical mastectomy,3 cases were received the repair of radioactivity ulcer in chest wall and 2 cases with recurrent breast cancer were repaired wound at stage one after reoperation. Results ：The largest area of flap was 25 cm × 14 cm, the minimum size was 16 cm × 8 cm. All 10 cases of flap were survived and abdominal wounds were sutured by directly draw. No serious complications were occured in patient＇s chest and abdomen. Fllowed up from 3 months to 3 years, the shape of the breast were satisfied. There had no hernia and obvious weak occurred in abdominal wall. Conclusions：The lower abdomen transverse flap based on the superior epigastric artery and central 1/3 part of rectus abdominal muscle bundle and former sheath has reliable blood supply, large area, simplified operation and it can effectively prevent the occurrence of the abdominal wall hernia and weak. It is an ideal choice for breast reconstruction and chest wall wound repair.
出处
《蚌埠医学院学报》
CAS
2010年第2期142-144,共3页
Journal of Bengbu Medical College
关键词
外科皮瓣
外科手术
整形
腹壁上动脉蒂
横形皮瓣
放射性溃疡
乳房重建
surgical rasps
surgery, plastic
the superior epigastric artery pedicle
the lower abdomen transverse flap
radiation ulcer
breast reconstruction
