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用邻近的皮肤修复软组织缺损,其颜色和质地都较好,这一点在头颈部尤为重要。自从Esser(1917年)首次使用带有知名血管皮下蒂的皮瓣以来,这种方法已有许多演变。作为增加皮瓣动度的方法有基底部蒂,从邻近皮肤向外伸出潜行皮瓣或仔细分离牵拉的纤维组织带等。如果不作潜行分离,皮瓣的推进完全取决于皮下组织的延展性。直到现在,尚无人报告使用潜行分离的皮瓣,这可能是由于害怕皮瓣坏死的缘故。头颈部血供丰富,可以使用蒂部很小的皮瓣。应注意的是皮下蒂的潜行分离要仔细,不要牵拉血管,使皮瓣获得最大的推进。以朝向缺损的方向做一长的斜行蒂,作最大程度的潜行分离,可增加皮瓣的推进度。只要皮下组织允许作蒂,这种皮瓣推进的距离可以很大,足以修复缺损。
With the adjacent skin to repair soft tissue defects, the color and texture are better, which is particularly important in the head and neck. This method has evolved a lot since Esser (1917) first used a flap with a well-known vascular subcutaneous pedicle. As a method of increasing the mobility of the flap there are pedicle pedicle, sneak out from the skin adjacent to the skin flap or carefully pull the separation of fibrous tissue and so on. If not sneak separation, flap advancement depends entirely on the ductility of subcutaneous tissue. Until now, no one reported the use of stealth separation flap, which may be due to fear of necrosis of the flap. Head and neck blood supply is rich, you can use pedicle skin flap. It should be noted that the subcutaneous pedicle sneak detachment to be careful, do not pull the blood vessels, so that the greatest advancement of the flap. In the direction of the defect to do a long oblique pedicle, for maximum sneak separation, increase the degree of propulsion of the flap. As long as the subcutaneous tissue is allowed to pedicle, the flap can be advanced a sufficient distance to repair the defect.