目的 探讨带蒂背阔肌皮瓣修复乳房软组织缺损的临床效果.方法 回顾性分析自2017年10月至2024年3月,广州中医药大学顺德医院骨伤二科收治的7例接受带蒂背阔肌皮瓣修复乳房软组织缺损的患者资料,乳房创面经清创后缺损面积为6.0 cm × 6.0 cm～18.0 cm × 10.0 cm,采用带蒂背阔肌皮瓣移植修复,并进行供区创面一期缝合;所取背阔肌皮瓣体积为8.0 cm × 8.0 cm × 0.5 cm～22.0 cm × 12.0 cm × 1.5 cm.术后随访观察患者皮瓣供区与受区的外观、温度、感觉、愈合等情况并通过疗效满意度评分表对创面预后情况进行评估.结果 7例患者随访2～12个月,移植后皮瓣及植皮均成活.6例供区经一期缝合后,愈合良好并留有线状瘢痕,1例出现边缘皮肤坏死,行植皮后恢复良好且其外形良好.7例创面痊愈,5例皮瓣形态接近正常,7例皮瓣感觉存在,6例皮瓣温度正常,7例背部供区无明显瘢痕增生.患者满意度评分为7.0～10.0分,平均9.0分.结论 带蒂背阔肌皮瓣修复乳房软组织缺损实用性较强、并发症较少、成功率较高,是修复乳房软组织缺损的可靠方法.
Observation on the applying tipped latissimus dorsi flap to repair breast soft tissue defects
Objective To investigate the clinical efficacy of pedicled latissimus dorsi myocutaneous flap in repairing breast soft tissue defects.Methods A retrospective analysis was conducted on seven female patients,who underwent latissimus dorsi flap surgery for breast soft tissue defects at Shunde Hospital of Guangzhou University of Chinese Medicine from October 2017 to March 2024.The size of the soft tissue defects ranged from 6.0 cm × 6.0 cm to 18.0 cm × 10.0 cm.The latissimus dorsi myocutaneous flap was used for repair,and the donor site was closed by primary suture.The size of the flaps ranged from 8.0 cm × 8.0 cm × 0.5 cm to 22.0 cm × 12.0 cm × 1.5 cm.Patients were followed up for observation of healing,temperature,sensation,and appearance at both donor and recipient sites.Results All seven patients were followed up for a period ranging from 2 to 12 months,during which all flaps and skin grafts survived.Six cases showed good healing with linear scars at the donor site after primary suture closure;one case experienced marginal skin necrosis but recovered well after skin grafting with a satisfactory appearance.In this study,the prognosis of trauma was evaluated by the efficacy satisfaction scale,in which 7 cases the trauma was healed,in 5 cases the flap morphology was close to normal,in 7 cases the flap sensation was present,in 6 cases the flap temperature was normal,and in 7 cases the dorsal donor area was free of obvious scarring.The patients'satisfaction scores ranged from 7.0 to 10.0,with a mean of 9.0.Conclusion Pedunculated latissimus dorsi flap is a reliable method for repairing breast soft tissue defects due to its high practicality,fewer complications and higher success rate.
Soft tissue defectLatissimus dorsi myocutaneous flap with pedicleWound repairBreast cancer
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