组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2014, Vol. 10 ›› Issue (6): 335-338.doi: 10.3969/j.issn.1673-0364.2014.06.009

• 论著 • 上一篇    下一篇

慢性胸壁放射性溃疡的分期修复

周耀东，管欣，章一新，冯少清，王峰，梁析，梁翔   

  1. 上海交通大学医学院附属第九人民医院胸外科；上海交通大学医学院附属第九人民医院整复外科
  • 发布日期:2020-07-23

Surgical Reconstruction of Chronic Radiation-induced Ulcer in Chest Wall by Stages

ZHOU Yaodong,GUAN Xin,ZHANG Yinxin,FEN Shaoqing,WANG Feng,LIANG Xi,LIANG Xiang   

  1. Department of Thoracic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine; Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine;
  • Published:2020-07-23

摘要： 目的探讨慢性胸部放射性溃疡缺损的修复方法。方法自2010年4月至2013年6月,对10例胸部慢性溃疡患者实行分期治疗。Ⅰ期清创,大网膜填塞;Ⅱ期行皮瓣转移修复创面,包括背阔肌带蒂移植及胸大肌肌皮瓣转移。术后观察手术疗效及并发症情况。结果术后随访26~37个月,平均随访25个月。所有患者无手术死亡,转移皮瓣无一例发生坏死。1例患者术后出现皮下积液,经抽液后加压包扎痊愈。其余患者无术后感染情况发生。患者术后呼吸功能良好,无反常呼吸运动。结论对于慢性溃疡的修复,分期治疗可取得较好的临床治疗效果。大网膜瓣适用于软组织缺损的充填,尤其是感染性软组织缺损。

关键词: 胸壁缺损, 慢性放射性溃疡, 分期治疗, 胸壁重建

Abstract: Objective To explore the surgical reconstruction of chronic radiation-induced ulcer in chest wall by stages. Methods From April 2010 to June 2013, 10 patients with huge chronic chest wall defect underwent chest wall reconstruction by stages. In stage Ⅰ, patients received debridement and greater omentum tamping; In stage Ⅱ, patients received surgical reconstruction by regional rotation flap, including pedicle latissimus dorsi myocutaneous flap and pectoralis major myocutaneous flap. The clinical efficacy and postoperative complications were observed. Results All the patients were followed up for 26-37 months （mean 25 months）. There were no operating death and local failure. One patient were suffered from subcutaneous infection which healed by debridement and drainage. No infection were observed in other patients. No paradoxical respiration occurred in all patients. Conclusion Stage therapeutics is effective in treating chronic radiation-induced ulcer and defect. Great omentum flap is useful for the repair of soft tissue defect, which is priority for defects caused by infection.

Key words: Chest wall defect, Chronic radiation-induced ulcer, Stage therapeutics, Chest wall reconstruction

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