REPAIR OF FACE AND UPPER LIMB DEFECTS WITH EXPANDED DELTO-PECTORAL AND ABDOMINALPERFORATOR FLAPS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Miaomiao , ZHAO Yu , WANG Chunlan , SUN Wei.

Department of Plastic Surgery, First Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230022, P.R.China.;

Corresponding author：

Keywords：

Soft tissue expansion; Delto-pectoral perforator flap; Deep inferior epigastric artery perforatorflap; Scar Wound repair

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【Abstract】 Objective To investigate the method and effectiveness of expanded delto-pectoral and abdominal
perforator flaps in repairing large defects of the face and upper limb after scar excision. Methods Between August 2000 and February 2011, 25 patients with large scars on face and upper l imb were treated. There were 14 males and 11 females with an average ageof 27 years (range, 7-36 years). Scars causes were burn and scald in 25 cases with a disease duration of 6 months to 7 years (mean, 4.5 years). The hypertrophic scars located at face in 15 cases, and at upper limb and hand in 10 cases. The soft tissue expanders (300-500 mL in volume) were implanted in the delto-pectoral zone and abdominal region in one-stage operation. In two-stage operation, after scars were resected, defects (9 cm × 7 cm to 17 cm × 8 cm) were repaired with the delto-pectoralperforator flaps (17 cm × 7 cm to 20 cm × 8 cm) in 15 facial scar cases and with the deep inferior epigastric artery perforator flaps (10 cm × 9 cm to 25 cm × 14 cm) in 10 upper limb and hand scar cases. The donor sites were sutured directly. Results Partial necrosis of the flaps occurred in 2 cases after operation, then the flap survived after expectant treatment. The other flaps and skin grafts survived successfully, and the incisions healed by first intention. Ten patients were followed up 6 months to 4 years. The
appearance, texture, and color of the flaps were similar to those at the donor site. Conclusion It is an effective method to use the delto-pectoral perforator flap and the deep inferior epigastric artery perforator flap for repairing soft tissue defects of the face and upper limb after scar excision.

Citation： ZHANG Miaomiao,ZHAO Yu,WANG Chunlan,SUN Wei.. REPAIR OF FACE AND UPPER LIMB DEFECTS WITH EXPANDED DELTO-PECTORAL AND ABDOMINALPERFORATOR FLAPS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(2): 223-226. doi: Copy

1.	Radovan C. Breast reconstruction after mastectomy using the temporary expander. Plast Reconstr Sury, 1982, 69(2): 195-208.
2.	杨大平, 唐茂林. 穿支皮瓣修复肢体软组织缺损的疗效观察. 中国修复重建外科杂志, 2011, 25(9): 1047-1050.
3.	王爱国, 邱勇. 股前外侧皮瓣远侧肌皮穿支的解剖学研究与临床应用. 中华骨科杂志, 2011, 31(3): 255-259.
4.	翁晓娟, 李小静, 宁金龙. 应用改进逆行腓肠神经营养血管皮瓣修复下肢软组织缺损. 中华显微外科杂志, 2010, 33(3): 190-193.
5.	张世民, 徐达传, 顾玉东. 穿支皮瓣. 中国临床解剖学杂志, 2004, 22(1): 32-33, 35.
6.	Taylor GI, Daniel RK. The anatomy of several free flap donor sites. Plast Reconstr Surg, 1975, 56(3): 243-253.
7.	汪良能, 高学书. 整形外科学. 北京: 人民卫生出版社, 1989: 172-173.
8.	王炜, 马奇, 鲁开化, 等. 整形外科学. 杭州: 浙江科学技术出版社, 1999: 247-248.
9.	Boyd JB, Taylor GI, Corlett R. The vascular territories of the superior epigastric and the deep inferior epigastric systems. Plast Reconstr Surg, 1984, 73(1): 1-16.
10.	EI-Mrakby HH, Milner RH. The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast Reconstr Surg, 2002, 109(2): 539-547.
11.	杨红岩, 徐军, 靳小雷, 等. 腹壁下动脉穿支皮瓣血管穿支及感觉神经的应用解剖. 中华整形外科杂志, 2004, 20(1): 27-29.
12.	Shang Z, Zhao Y, Ding H, et al. Repair of hand scars by a dilated deep inferior epigastric artery perforator flap. J Plastic Surg Hand Surg, 2011, 45(2): 102-108.
13.	Kanno S, Oda N, Abe M, et al. Establishment of a simple and practical procedure applicable to therapeutic angiogenesis. Circulation, 1999, 90(20): 2682-2687.
14.	庄跃宏, 徐达传, 唐茂林. CT血管造影在皮瓣外科的研究进展. 中国临床解剖学杂志, 2010, 28(4): 469-472.
15.	黎洪棉, 高建华, 梁自乾, 等. 应用彩色多普勒影像技术设计腹部轴型皮瓣修复手腕部深度创面. 中华手外科杂志, 2006, 22(6): 353-355.

1. Radovan C. Breast reconstruction after mastectomy using the temporary expander. Plast Reconstr Sury, 1982, 69(2): 195-208.
2. 杨大平, 唐茂林. 穿支皮瓣修复肢体软组织缺损的疗效观察. 中国修复重建外科杂志, 2011, 25(9): 1047-1050.
3. 王爱国, 邱勇. 股前外侧皮瓣远侧肌皮穿支的解剖学研究与临床应用. 中华骨科杂志, 2011, 31(3): 255-259.
4. 翁晓娟, 李小静, 宁金龙. 应用改进逆行腓肠神经营养血管皮瓣修复下肢软组织缺损. 中华显微外科杂志, 2010, 33(3): 190-193.
5. 张世民, 徐达传, 顾玉东. 穿支皮瓣. 中国临床解剖学杂志, 2004, 22(1): 32-33, 35.
6. Taylor GI, Daniel RK. The anatomy of several free flap donor sites. Plast Reconstr Surg, 1975, 56(3): 243-253.
7. 汪良能, 高学书. 整形外科学. 北京: 人民卫生出版社, 1989: 172-173.
8. 王炜, 马奇, 鲁开化, 等. 整形外科学. 杭州: 浙江科学技术出版社, 1999: 247-248.
9. Boyd JB, Taylor GI, Corlett R. The vascular territories of the superior epigastric and the deep inferior epigastric systems. Plast Reconstr Surg, 1984, 73(1): 1-16.
10. EI-Mrakby HH, Milner RH. The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast Reconstr Surg, 2002, 109(2): 539-547.
11. 杨红岩, 徐军, 靳小雷, 等. 腹壁下动脉穿支皮瓣血管穿支及感觉神经的应用解剖. 中华整形外科杂志, 2004, 20(1): 27-29.
12. Shang Z, Zhao Y, Ding H, et al. Repair of hand scars by a dilated deep inferior epigastric artery perforator flap. J Plastic Surg Hand Surg, 2011, 45(2): 102-108.
13. Kanno S, Oda N, Abe M, et al. Establishment of a simple and practical procedure applicable to therapeutic angiogenesis. Circulation, 1999, 90(20): 2682-2687.
14. 庄跃宏, 徐达传, 唐茂林. CT血管造影在皮瓣外科的研究进展. 中国临床解剖学杂志, 2010, 28(4): 469-472.
15. 黎洪棉, 高建华, 梁自乾, 等. 应用彩色多普勒影像技术设计腹部轴型皮瓣修复手腕部深度创面. 中华手外科杂志, 2006, 22(6): 353-355.

Chinese Journal of Reparative and Reconstructive Surgery

REPAIR OF FACE AND UPPER LIMB DEFECTS WITH EXPANDED DELTO-PECTORAL AND ABDOMINALPERFORATOR FLAPS

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