论文部分内容阅读
目的 通过应用腹壁下动脉穿支游离皮瓣移植进行乳房再造的手术方法 ,总结应用该方法进行乳房再造的临床经验。方法 切取以腹壁下动静脉为蒂的穿支游离皮瓣 ,将腹壁下动静脉与胸廓内动静脉相吻合 ,进行乳房再造。结果 自 2 0 0 0年以来 ,临床应用腹壁下动脉穿支皮瓣再造乳房共 15例 ,10例皮瓣 10 0 %成活 ,2例皮瓣远端局部皮肤坏死 ,1例皮瓣远端脂肪硬结 ,2例皮瓣完全坏死。随访6个月至 1年 ,再造乳房外形满意 ,供区无腹壁疝、腹壁膨出、腹壁薄弱等并发症发生。结论 腹壁下动脉穿支游离皮瓣是下腹部横行腹直肌肌皮瓣 (TRAM皮瓣 )的技术改良与发展 ,该皮瓣具有血运丰富、组织量大、易于塑形、供区损伤小等优点 ,是一种安全可靠的乳房再造方法。
Objective To summarize the clinical experience of using this method for breast reconstruction through the application of the surgical method of transplanting the free flap of the inferior abdominal artery perforator for breast reconstruction. Methods The perforator pedicle flap pedicled with the inferior veins of the abdominal wall was excised and the anastomosis of the inferior abdominal wall and vein was matched with the internal thoracic artery and vein for the reconstruction of the breast. Results From 2000, there were 15 cases of breast reconstruction with subclinical flaps of inferior abdominal artery, 10 cases of flap survival of 10 cases, 2 cases of distal skin flap necrosis and 1 case of distal flap fat flap Sclerosis, 2 cases of complete necrosis of the flap. Followed up for 6 months to 1 year, reconstruction of breast shape satisfactory for the area without abdominal hernia, abdominal wall bulging, abdominal weakness and other complications. Conclusions The free flap of inferior abdominal artery perforating branch is the technique improvement and development of transversal rectus abdominis musculocutaneous flap (TRAM flap). The flap has the advantages of abundant blood supply, large amount of tissue and easy shape, And other advantages, is a safe and reliable method of breast reconstruction.