Release of Anterior Neck Contracture with Supraclavicular Island Flap-Case Report

利用鎖骨上島狀皮瓣以鬆解前頸部疤痕攣縮病例報告

陳恒常(Heng-Chang Chen)

《中華民國整形外科醫學會雜誌》 10卷4期 (2001/12) Pp. 292-297

https://doi.org/10.7096/JPSA.200112.0292

摘要

頸部的疤痕攣縮常是治療或預防復發的難題。單純線條狀的疤痕容易以乙字成形術鬆解，較嚴重的攣縮病例則在切除疤痕後需要大面積的植皮或皮瓣來覆蓋。介於其中，有些只影響到前頸中央部份的疤痕，可運用一較簡單的島狀皮瓣來重建此畸形。利用頸部兩側、鎖骨上方常倖免於燙傷的皮膚，以鎖骨上動脈血管莖的島狀皮瓣向前頸部推進，可以單次手術有效解決此類攣縮。手術中不必變換病患體位，移轉之皮瓣質地相仿且不易復發攣縮，術後可免除長久穿戴頸圈的不便。誠為一適合侷限於前頸部狹窄疤痕所適用的術式。

並列摘要

Neck contracture is frequently a treatment dilemma. Most severe cases will require large-scale skin graft or flap, staged procedures, and long term cervical splinting for optimal result. For neck contracture with only the anterior central segment is involved, a pedicled island flap from the neighboring supraclavicular area may correct this deformity in a single session. The neck scar is incised horizontally with connection to the fusiform island flap from the supraclavicular area, and the contracture is released by anterior transposition as V-Y advancement. This is a simple and reliable operation, and there is no need to change position during the operation. The patient may be waived from burden of long term postoperative cervical splinting with excellent skin appearance matching. We will preset a case of flame burn more than 90% TBSA with anterior neck contracture successfully reconstructed with this modified supraclavicular flap.

並列關鍵字

neck contracture ； supraclavicular flap