Early Reconstruction with Multiple Flaps in Complicated Head and Neck Acute Burn Injury-Case Report

用多重皮瓣來重建頭頸部複雜的急性燒傷－病例報告

洪士晉(Shyh-Jinn Hung) ； 楊瑞永(Jui-Yung Yang) ； 陳宏基(Hung-Chi Chen) ； 魏福全(Fu-Chan Wei)

《中華民國重建整形外科醫學會雜誌》 8卷2期 (1999/06) Pp. 143-149

https://doi.org/10.7096/JPRSA.199906.0011

摘要

嚴重電灼傷及接觸性灼傷所造成的既深且廣泛的傷口對外科醫師是一項挑戰。我們在此報告一個複雜的病例因爲頭頸部壓碎及熱燒傷而造成頭顱碎裂及兩側枕骨、額骨、頂骨和大血管裸露。在完成初步急救之後，我們以早期清創與皮瓣重建使其避免敗血症以挽救他的生命。我們用兩側大胸肌肌皮皮瓣、正中前額皮瓣以及左側斜方肌肌皮皮瓣來進行軟組織的重建。雖然在住院期間有一次來自末覆蓋傷口的感染而造成嚴重的敗血症危及病人的生命；但是病人最後平安的存活下來並回到了原先的工作崗位繼續工作而幾乎沒有任何不便。一年的追蹤發現在頸部沒有疤痕緊縮的現象。

並列摘要

It is difficult for a surgeon to deal with the extensive and deep wounds due to severe electric and contact thermal burn. We present a complicated case who sustained severe crushing and thermal burn injuries over his head and neck, which resulted in skull bone fracture and exposure of bilateral frontoparietal and occipital bones as well as great vessels. After resuscitation, early debridement and flap reconstruction were peformed to salvage his life. Bilateral pedicle pectoralis major myocutaneous flaps, pedicle midline forehead flap and left pedicle trapezius myocutaneous flap were used for soft tissue reconstruction. The patient eventually survived although he had an episode of severe sepsis resulted from infected wound. He returned to his original full-time job without disability. There is no scar contracture at the neck area after one-year follow-up.

並列關鍵字

burn ； head and neck ； pectoralis major flap ； trapezius flap ； forehead flap