Reconstruction of 41 cases of large chest keloids with the pre-expanded internal mammary artery perforator flap
10.3760/cma.j.cn114453-20211228-00488
- VernacularTitle:应用预扩张胸廓内动脉穿支皮瓣修复41例胸部大面积瘢痕疙瘩手术创面
- Author:
Zheng QI
1
;
Tian MENG
;
Kexin SONG
;
Cheng FENG
;
Zhengyun LIANG
;
Wenbo LI
;
Fuquan ZHANG
;
Lingyan KONG
;
Ning DING
;
Youbin WANG
Author Information
1. 中国医学科学院北京协和医学院北京协和医院整形美容科，北京 100031
- Keywords:
Keloid;
Thorax;
Surgical flaps;
Pre-expanded internal mammary artery perforator flap;
Radiotherapy
- From:
Chinese Journal of Plastic Surgery
2022;38(6):635-639
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical effects of the pre-expanded internal mammary artery perforator flap in large chest keloids surgical treatment.Methods:Patients with large chest keloid were treated with the pre-expanded internal mammary artery perforator flap between January 2017 and September 2021. The surgical treatment was divided into two different phases. In the first phase, a tissue expander was implanted beneath the skin within the angiosome of the internal mammary artery perforator. The expander was injected with normal saline once a week. In the second phase, the expander and the keloid tissue were removed, and a pre-expanded internal mammary artery perforator flap was designed to cover the wound. Radiotherapy and hyperbaric oxygen therapy were performed in the postoperative period. The treatment effect was followed up. The postoperative complications were analyzed, and the recurrence and patient satisfaction rates were recorded.Results:A total of 41 patients were enrolled, including 20 male and 21 female patients. The patients’ age ranged from 24 to 64, with a mean disease history of 11.9 years. The mean size of the keloid was 9 cm × 8 cm. Some patients were treated with one expander, but four expanders were needed in some extensive cases. The volume of the expander ranged from 80 to 600 ml. The mean volume was 300 ml, with a mean expansion time of 3 months. The mean flap size was 9 cm × 8 cm. Two cases with distal necrosis were observed. Five cases suffered from partial incision scar hyperplasia. No recurrence occurred during the followed-up period. Thirty-six patients (87.8%) were satisfied with the operation effect, and five (12.2%) thought the effect was acceptable.Conclusions:The pre-expanded internal mammary artery perforator flap is an effective treatment for the large chest keloid. It can provide sufficient skin tissue for wound repair, with a stable blood supply and an excellent curative effect.
