Island Pedicle Thoracodorsal Perforator Flap and Random Transpositional Flap for Bilateral Axillary Burn Scar Contracture-Case Report

使用根蒂式胸背穿通枝皮瓣與轉移位皮瓣重建雙側腋下燒傷疤痕攣縮－病例報告

方前量(Chien-Liang Fang) ； 唐友文(Yu-Wen Tang) ； 林雍球(Yung-Chiu Lin) ； 顏榮信(Jung-Hsing Yen) ； 陳伊呈(I-Chen Chen)

《中華民國整形外科醫學會雜誌》 15卷3期 (2006/09) Pp. 292-298

https://doi.org/10.7096/JPSA.200609.0292

摘要

治療腋下燒傷疤痕攣縮是很困難的因為經常伴隨有上肢，軀幹和頸部之燒傷過度增生之肥厚疤痕組織。有很多種方法用來治療腋下疤痕攣縮但治療的方式必須因人而異，必須依據不只是疤痕攣縮的嚴重度，還有腋下局部組織狀況，像是腋下皺褶的疤痕情形，是否影響到腋窩，周圍皮膚疤痕多寡。我們報告一個十一歲的小朋友使用根蒂式胸背穿通枝皮瓣與轉移位皮瓣重建雙側腋下燒傷疤痕攣縮的病例報告。臨床結果顯示轉移位皮瓣在腋下有足夠健康組織下是簡單，有效律和安全的技術。當腋下結痂嚴重時根蒂式皮瓣像是胸背穿通枝皮瓣便可使用於重建。在重建手術後都可以達到滿意的肩關節功能與美觀上的效果。在重建手術後都可以達到滿意的肩關節功能與美觀上的效果。

並列摘要

Axillary burn scar contractures are difficult to treat due to that they are usually associated with hypertrophic burn scars of upper extremities, trunk and neck. There are many methods to treat axillary scar contracture but the optimal therapeutic method must be individualized, depending on not only the severity of the contracture itself but also the local anatomic conditions, such as scarring of the axillary folds and amount of scarring of adjacent skin. We present one case of 11 y/o child using island pedicle thoracodrosal perforator flap for right and random transpositional flap for left axillary burn scar contractures. Clinical results indicated that transpositoinal flap is a simple, efficient, and reliable technique in release of axillary scar contracture if healthy skin tissue is enough in axilla. If there is severe scarring of axillary tissue, pedicle flap such as thoracodorsal perforator flap may be considered. They both achieve good functional and cosmetic results after reconstruction.

並列關鍵字

axillary burn scar contracuture ； thoracodorsal perforator flap ； transpositional flap