颈横动脉颈段皮支皮瓣的临床应用

目的 探讨颈前瘢痕及严重的颏胸黏连、胸前瘢痕癌等的治疗方法。方法 颈横动脉起自甲状颈干后，向外行走于胸锁乳突肌、肩胛舌骨肌深面。皮支在胸锁乳突肌与肩胛舌骨肌交点处穿出，并营养锁骨上、下区及前胸区皮肤。本组46例患者，颈部瘢痕及严重的颏胸黏连45例，胸前瘢痕癌1例，均采用颈横动脉颈段皮支皮瓣转移修复。术中先将颈部瘢痕切除，充分松解挛缩后或将肿瘤切除后，在锁骨上、下及前胸区依创面大小，结合颈横动脉颈段皮支的应用解剖，设计皮瓣，转移到受区。如供区采用预扩张术，则供区创面可拉拢缝合。否则。供区需采用断层或全厚皮片移植修复。结果 本组46例患者，11例为带蒂皮瓣转移，余均为岛状皮瓣转移，颏胸黏连完全纠正，术后效果满意。结论 采用颈横动脉颈段皮支皮瓣修复颏胸黏连、胸前瘢痕癌等，手术可一次完成，无继发畸形，是目前较理想的治疗方法。

Clinical application of flaps taken from the cervical cutaneous branch of transverse cervical artery

Objective To explore the surgical treatment for chin-thoracic conglutination, anterior thoracic regional tumors, and so on. Methods The transverse cervical artery starts from the thyroeervical trunk. The segment from the starting point to the front boundary of the trapezius muscle is called the cervical segment of the transverse cervical artery. It extends outward beneath the stemo - mastoid muscle and the omohyoid muscle. The cutaneous branch of cervical segment perforates from the crossing point of the above two muscles, nutriting the skin of the upper and lower regions of the clavicle and the chest wall. The total of 46 cases, 45 cases of cervical scar and serious mental stermal adhesions, and 1 case of scar carcinoma on chest wall, dealed with the application of the flap of the branch of the cervical segment of the transverse cervical artery to repair the. After removing the cervical scar or cacinoma, the flaps were designed according to the size of the wound to be repaired, and the clinical anatomy of cutaneaus branch of cervical segment. The donor site secondary wound can be closed directly with expanded donor region, or closed by free skin graft without pre- expansion. Results Of the 46 successful cases, 11 were treated with transplanted pedicle flaps and the rest with transplanted island flaps. Conclusion The treatment of chin - thoracic conglutination and anterior thoracic regional tumors with flaps taken from the cervical cutaneous branch of transverse cervical artery is completed primarily without secondary complications. It is the ideal and effective method to treat those scares.