- 期刊
Reconstruction of Anterior Cervical Contractures with a Free Thin Anterolateral Thigh Flap Combined with Cervicoplasty
使用薄前旁側大腿自由皮瓣合併頸部整形術做前頸部攣縮之重建
摘要
薄前旁側大腿自由皮瓣合併頸部整形術，被使用於一位二十二歲，二度和三度火焰灼傷，佔全身體表面積百分之四十之男性病患。在 26 公分長 5 公分寬的橢圓形灼傷疤痕被切除後，疤痕攣縮緩解 3 公分，並使用病患右大腿取下之前旁側大腿自由皮瓣來覆蓋傷口，並以網狀化半厚度植皮來覆蓋。此自由皮瓣存活良好。病患住院天數為10天。追綜病患10個月後，其頸部功能如下：頸部及下頷夾角改善30度（術前150度，術後120度），頸部伸張角度增加48度（術前82度，術後130度）；頸部旋轉角度增加13度（術前57度，術後70度）；頸部旁側屈曲角度增加10度（術前25度，術後35度）。取皮瓣處傷口無發症產生。這個病例報告顯示了，使用前旁側大腿自由皮瓣合併頸部整形術，具有能單一階段重建頸部外廓（可削薄），並提供具有彈性特性之皮瓣及低取皮瓣處傷口併發症的優點。
關鍵字
無資料並列摘要
A free thin anterolateral thigh (ALT) flap combined with cervicoplasty was used in one patient with a second and third degree flame burn of 40% TBSA (total body surface area) involvement, who underwent reconstruction at Chang Gung Memorial Hospital. A 26×5 cm elliptical scar was excised. A free thin ALT flap (26×8 cm) was harvested from the right thigh. The flap survived well. The hospital stay was 10 days. The donor site was covered with meshed split thickness skin graft. At a follow-up time of 10 months, the functional improvement was measured as follows: The cervicomandibular angle improved by 30 degrees (from preoperative 150 degrees to postoperative 120 degrees). The release of contracture was 3 cm. An increase of 48 degrees in cervical extension (from preoperative 82 to postoperative 130 degrees); an increase of 13 degrees in cervical rotation (from preoperative 57 to postoperative 70 degrees); and an increase of 10 degrees in cervical lateral flexion (preoperative 25 to postoperative 35 degrees). No donor site morbidity was found. This case demonstrated that the advantages of using the free thin ALT flap combined with cervicoplasty were in providing a one-staged reconstruction with a thin and pliable flap that achieved good cervical contour with low donor site morbidity.
延伸閱讀
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