腹直肌肌皮瓣修复胸部慢性放射性溃疡的应用

发布时间：2018-03-30 18:31

本文选题：胸部　切入点：放射性溃疡　出处：《中华损伤与修复杂志(电子版)》2016年05期

【摘要】：目的总结应用腹直肌肌皮瓣修复胸部慢性放射性溃疡的经验。方法 2010年以来收治胸部深度放射性溃疡6例,全身麻醉下行胸壁放射性溃疡创面清创,切除坏死软组织及变性肋骨,根据缺损大小及形状,切取带有腹壁上动静脉血管蒂的腹直肌肌皮瓣转移修复胸壁缺损,重建胸壁。其中4例采用纵行腹直肌肌皮瓣;2例采用横行腹直肌肌皮瓣修复,供瓣区给予游离皮片移植或缝合修复。结果 1例患者皮瓣边缘与创缘愈合不佳,给予扩大切除局部病变皮肤范围后缝合修复。其余皮瓣成活良好,创面修复满意。术后随访1~3年,溃疡无复发,供瓣区无腹壁疝形成。结论清创后,应用血运丰富的腹直肌肌皮瓣覆盖,可有效修复胸部慢性放射性溃疡,是一种简单、安全、有效的治疗方法。
[Abstract]:Objective to summarize the experience of rectus abdominis myocutaneous flap in repairing chronic radiation ulcer of chest.Methods six cases of chest deep radiation ulcer were treated in our hospital since 2010. The wound of chest wall radiation ulcer was debrided under general anesthesia. Necrotic soft tissue and degenerated ribs were removed according to the size and shape of the defect.Rectus abdominis musculocutaneous flap with superior abdominal arteriovenous pedicle was used to repair chest wall defect and reconstruct chest wall.Among them 4 cases were treated with longitudinal rectus abdominis myocutaneous flap 2 cases were repaired with transverse rectus abdominis myocutaneous flap and the donor region was repaired with free skin graft or suture.Results the edge and wound edge of skin flap were not well healed in one case.The remaining flaps survived well and the wounds were repaired satisfactorily.Conclusion after debridement, it is a simple, safe and effective method to repair chronic radiation ulcer of chest by using rectus abdominis myocutaneous flap with abundant blood circulation.
【作者单位】：海南省人民医院烧伤与皮肤修复外科;
【基金】：海南省自然科学基金项目(11189)
【分类号】：R632.1

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