目的 探讨扩张的锁骨上皮瓣修复面颈部瘢痕的治疗效果.方法 2010年10月至2013年11月,对16例面颈部瘢痕畸形患者,采用以颈横动脉锁骨上皮支为血管蒂的扩张锁骨上皮瓣修复.一期在前胸部埋置扩张器(400 ～600) ml,二期行瘢痕切除、松解及扩张皮瓣修复术,供瓣区直接拉拢缝合.结果 本组16例患者的皮瓣切取面积为12 cm×7 cm ～ 22 cm×11 cm,皮瓣均存活,仅1例患者出现血肿,经行血肿清除术后痊愈.术后经3 ～12个月的随访,皮瓣颜色和质地与受区周围正常皮肤一致,外观无臃肿、切口瘢痕增生不明显.结论 应用扩张的锁骨上皮瓣修复面颈部瘢痕,外形及功能恢复良好,是一种理想的修复方法.%Objective To observe the therapeutic effect of expanded supraclavicular island flaps for facial and cervical scar.Methods From Oct.2010 to Nov.2013,a series of 16 patients with facial and cervical scars were treated by the expanded supraclavicular island flaps,pedicled by the supraclavicular cutaneous branch of transverse cervical artery.In the first stage,the soft tissue expanders (ranging from 400 ml to 600 ml in volume) were implanted in the anterior thoracic region.In the second stage,the facial and cervical scars were removed and the contructures were released,the expanded flap was transferred to cover the defects.The wounds at the donor sites were closed directly.Results The flaps size ranged from 12 cm × 7 cm to 22 cm × 11 cm.All flaps survived with no flap necrosis.Hematoma occurred in one case and healed by debridement.16 patients were followed up for 3-12 months.The color and texture of all flaps matched well with the surrounding skin tissue,no bulky appearance or hypertrophic scar were noticed.Conclusions The expanded supraclavicular island flap is a good choice for repairing facial and cervical scar.The appearance and function can be improved.
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