雙Z菱形皮瓣手術之臨床應用

Clinical Application of Double-Z Rhomboid Flap

葉文中(Wen-Chung Yeh) ； 張忠強(Chung-Chiang Chang) ； 張國華(Kau-Hwa Chang) ； 石奉周(Feng-Chu Shih)

《中華民國重建整形外科醫學會雜誌》 5卷3期 (1996/09) Pp. 167-176

https://doi.org/10.7096/JPRSA.199609.0007

摘要

因外傷或腫瘤切除後所引起的軟組織缺損，時常考慮以局部皮瓣來重建。臨床上常使用的菱形皮瓣為一應用範圍很廣的局部皮瓣。然而對於大範圍的重建則有某些限制，如供皮區縫合時張力太大，疤痕不與鬆弛皮膚張力線平行等。雙Z菱形皮瓣運用缺損區兩側的組織來重建，可以有效克服上述缺點。其優點為：可重建較大範圍的缺損，縫合後疤痕較為美觀，近關節處的重建可早日活動，避免關節僵直，供皮區不須植皮術等。
本院使用橡皮片做成傷口皮瓣研究模式，來分析不同設計方式的雙Z菱形皮瓣的傷口張力變化，並提出本院的設計方式以減低皮瓣尖端張力及壞死。結果顯示橡皮片的研究模式是一個良好的皮瓣研究模式，我們5年來20個病例也證明雙Z菱形皮瓣是一個實用的皮瓣。

關鍵字

菱形皮瓣 ； 雙Z菱形皮瓣術

並列摘要

Local flap is often used for reconstruction of soft tissue defect due to trauma or tumor excision. Rhomboid flap is one of the local flap frequently used for these purposes. However, as with all flaps, rhomboid flap has some limitations including excessive tension and suboptimal scar orientation in resurfacing large defect. The double-Z rhomboid flap which borrows tissue from two contralateral sides of the defect for reconstruction may correct these problems. Its advantages include larger defect could be repaired, optimal scar orientation, decreases joint stiffness and avoids donor site skin graft.
We used the rubber glove model to analyze the dynamic difference from several design modifications with our modification for decreasing flap tip tension and necrosis. The result showed rubber glove model is a good model for study of flaps and our clinical application of double-Z rhomboid flap in 20 patients proves it to be a useful flap.

並列關鍵字

rhomboid flap ； double-Z rhomboid flap