沈祖尧 100035 北京积水潭医院烧伤科修复重建与整形研究室 中华整形烧伤外科杂志 1999 0 15 1


    关键词：乳房重建；肌皮瓣；放射溃疡 期刊 zhzxsswkzz 0 美容外科 fur -->


    

【摘要】 目的 用改善血供的下腹部横行腹直肌肌皮瓣(TRAMF)重建乳房。方法 在通常以上部腹直肌为蒂的TRAMF的肌蒂表面附加一块脐旁三角形皮瓣，使共同组成三叶状，藉以增加肌皮穿支动脉的血供及肌皮瓣提供的组织量，便于乳房塑形和腋部瘢痕挛缩的充分松解修复，以及胸壁的放射性烧伤创面的修复。结果 乳癌术后单侧乳房缺失伴胸壁放射性溃疡及腋部瘢痕挛缩6例，肌皮瓣完全成活者4例，皮瓣最远端少量坏死及脂肪液化者2例。重建乳房外形良好，胸壁放射性烧伤创面修复及腋部瘢痕挛缩修复。结论 本术式最适用于单侧乳房缺失伴放疗后有胸壁烧伤溃疡及腋窝瘢痕挛缩的病例。

    Breast reconstructionusing pedicled three-lobe transverse rectus abdominis musculocutaneous flap

    SHEN Zuyao.

    Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035

【 Abstract 】 Objective Aninnovated transverse rectus abdominis musculocutaneous flap, the three-lobe TRAM flap wasdesigned for breast reconstruction. Methods A triangle-shaped skin overthe upper part of the rectus abdominis muscle was included in the conventional TRAM flapfor the purpose of adding more skin for breast reconstruction and enhancing blood supplyof the skin portion of the TRAM flap. Results In this group of sixpatients subjected to mastectomy and radiation therapy for breast cancer, completesurvival of the three-lobe TRAM flap was obtained in 4 cases. Two patients had minor skinnecrosis and fat liquefaction. Better breast contour and contracture release of the axillawere also achieved.Conclusion This innovation of conventional TRAM flapfor breast reconstruction has some advantages. It is especially useful for patientscomplicated with radiation lesions on the chest and axilla areas.

     【 Keywords】 Breastreconstruction Musculocutaneous flap Radiation ulcer

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