旋髂浅动脉岛状分叶皮瓣在修复下腹部和会阴区瘢痕挛缩中应用.docVIP

旋髂浅动脉岛状分叶皮瓣在修复下腹部及会阴区瘢痕挛缩中的应用 韩军涛，谢松涛，淘克，计鹏，张万福，胡大海 （第四军医大学西京医院烧伤与皮肤外科，陕西 西安，710032） 【摘要】目的 探讨以旋髂浅动脉为蒂的岛状皮瓣在修复下腹部及会阴区瘢痕挛缩中的应用，及其远端分叶皮瓣的设计。 方法 22例下腹部至会阴区有广泛性瘢痕增生及挛缩畸形的患者，采用单侧或双侧以旋髂浅动脉为蒂的岛状皮瓣进行修复，皮瓣远端设计长宽比例1:1～3:1的分叶瓣，用以覆盖重要功能区，供瓣区直接缝合或移植自体中厚皮。结果 22例患者共24个皮瓣均存活良好，皮瓣色泽正常，外生殖器外形及功能正常，随访3月～2年，未出现继发性挛缩。结论 以旋髂浅动脉为蒂的岛状皮瓣可良好地修复下腹部及会阴区的瘢痕挛缩，且其远端分叶瓣的长宽比可超出随意皮瓣的设计限制。 【关键词】旋髂浅动脉；岛状皮瓣；下腹部；会阴部；瘢痕挛缩 Application of superficial iliac circumflex artery island flaps in repairing cicatricial contracture of hypogastric and perineal region Han Jun-tao, Xie Song-tao, Tao Ke, Ji Peng, Zhang Wan-fu, Hu Da-hai. Burns centre of PLA, Department of Burns and Cutaneous Surgery, Xijing Hospital Fourth Military Medical University，Xi’an 710032, Shaanxi Province, P.R.China Corresponding author: Hu Da-hai, Email:burns@fmmu.edu.cn, Tel: 029【Abstract】Objective To evaluate the results of superficial iliac circumflex artery (SICA) island flaps in repairing cicatricial contracture of hypogastric and perineal region and discuss the design of lobulated skin flap on it. Methods 22 cases with extensive scar and cicatricial contracture in hypogastric and perineal region were involved. All of them were repaired with SICA island flaps and the length breadth ratio of lobulated skin flap was from 1:1 to 3:1. The donor site was sutured directly or was closed by split thickness skin transplantation. Results All cases with 24 flaps survived satisfactorily. The patients were satisfied with the repair in the contour, function and color of this region. The contracture has not recurred after being followed from 3 months to 2 years. Conclusion SICA island flap was ideal in repairing cicatricial contracture of hypogastric and perineal region and the design for lobulated skin flap on it could break the restriction of random flap. [Key words] superficial iliac circumflex artery; island flap; hypogastric region; perineal region cicatricial contracture 下腹部、会阴区、耻骨联合区并非常见的烧伤部位，可一旦出现深度烧伤，由于其组织器官特殊的解剖学特点及功能，易导致