摘要
目的探讨在颏颈瘢痕粘连畸形矫正术中应用颈阔肌瘢痕组织瓣成形下颏和颈部轮廓的方法及疗效。方法 2004年4月-2011年8月,收治26例颏颈及颏颈胸瘢痕粘连患者。男15例,女11例;年龄12～31岁,平均18岁。热液烫伤19例,火焰烧伤7例。损伤分度:深Ⅱ度23例,Ⅲ度3例。伤后瘢痕形成6～27个月,平均10个月。颏颈角(117.10±14.46)°,颈颏角(143.38±15.68)°。颏颈瘢痕粘连畸形矫正术中,采用大小为8 cm×7 cm～10 cm×8 cm的颏下颈阔肌瘢痕组织瓣行颏颈部轮廓成形,中厚皮片游离移植修复颈部创面。结果术后颈阔肌瘢痕组织瓣和皮片均顺利成活,切口Ⅰ期愈合。患者均获随访,随访时间6个月～3年,平均16个月。术后2周测量颏颈角为(89.31±6.30)°,颈颏角为(117.83±10.65)°,与术前比较差异均有统计学意义(P<0.05),分别与正常值90°及120°比较差异均无统计学意义(P>0.05)。21例颏颈角和颈颏角在正常范围的患者对颏颈部外观和颈部后仰功能恢复满意。结论颏下颈阔肌瘢痕组织瓣翻转垫高下颏部,同时缩小颏颈角和颈颏角,可有效改善颏颈部外观,是一种矫正颏颈瘢痕粘连畸形的有效方法。
Objective To investigate the procedures and effectiveness of platysma scar flap for reconstructing mentocervical appearance in patients with mentocervical cicatricial contracture deformity. Methods Between April 2004 and August 2011, 26 patients with mentocervical cicatricial contracture deformities were admitted. There were 15 males and 11 females, aged 12-31 years （mean, 18 years）. The causes included scald injury in 19 cases and flame injury in 7 cases, including 23 cases of deep second degree burn and 3 cases of third degree burn. The time between injury and scar formation was 6-27 months （mean, 10 months）. The mentocervical angle was （117.10 _＋ 14.46）~, and the cervicomental angle was （143.38 _＋ 15.68）~. The platysma scar flap transfer （8 cm x 7 cm to 10 cm ~ 8 cm in size） and skin grafting were performed to reconstruct mentocervical appearance. Results The flap and skin graft all survived and the incisions healed by first intention. All the patients were followed up 6 months-3 years （mean, 16 months）. The mentocervical and cervicomental angles were significantly reduced to （89.31 _＋ 6.30） and （117.83 ＋ 10.65）respectively at 2 weeks after operation （P 〈 0.05）, showing no significant difference when compared with normal mentocervical angle （90） and cervicomental angle （120~） （P 〉 0.05）. The satisfactory results of the mentocervical appearance and cervical extension function were obtained in 21 patients whose mentocervical and cervicomental angles were restored to normal. Conclusion Platysma scar flap transfer is an effective method to reconstruct mentocervical appearance and reduce mentocervical and cervicomental angles in patients with mentocervical cicatricial contracture deformity.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第12期1489-1491,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
颏颈瘢痕粘连
颈阔肌瘢痕组织瓣
颏颈角
颈颏角
Mentocervical cicatricial contracture Platysma scar flap Mentocervical angle Cervicomentalangle
