Application of perforator pedicled flap in the treatment of trunk keloids
10.3760/cma.j.cn114453-20191022-00315
- VernacularTitle:穿支蒂皮瓣在躯干部瘢痕疙瘩治疗中的应用
- Author:
Ye SHEN
1
;
Lingli GUO
;
Baishi WANG
;
Jing REN
;
Bo ZHOU
Author Information
1. 解放军总医院整形修复科，北京 100853
- Keywords:
Surgical flap;
Perforator flap;
Flap, pedicled;
Keloid;
Combined modality therapy
- From:
Chinese Journal of Plastic Surgery
2020;36(8):887-892
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application effect of perforator pedicle flap in the wound repair after resection of the medium and large-sized keloids in the trunk.Methods:From January 2018 to January 2019, 10 patients, aged from 20 to 53 years old, with medium and large-sized keloids in the trunk were treated, including 3 cases in the anterior chest, 3 cases in the umbilical region, 4 cases in the lower abdomen, 8 cases were women and 2 cases were men. The size of keloids were 2.0 cm×3.0 cm to 5.0 cm×9.0 cm, and all keloids were accompanied with infection. Scars and infected tissues were removed and contracture was released completely. Pedicled flaps with intercostal perforator artery(3 cases), paraumbilical perforator artery(3 cases) or groin perforator artery(4 cases) were elevated and advanced or rotated to cover the wound. Early radiotherapy was delivered to the scar bed 5-10 Gy each time with a total dose of 15 to 20 Gy over 3 daily fractions after surgery. And other treatments, such as topical silicone gel, corticosteroid intralesional injection and elastic clothing compression were taken as adjuvant therapy. The scars were assessed by the Vancouver Scar Scale, and local morphology, hair distribution, itching, pain and patient satisfaction were analyzed and evaluated after 12 months to 24 months follow-up.Results:All flaps survived and the incisions healed primarily. The local morphology and hair distribution were normal, and the itching and pain were relieved obviously. The Vancouver Scar Scale scores vary from 1 to 6 in 9 patients. Incision hypertrophic scar with the Vancouver Scar Scale score of 9 occurred in one noncompliance patient who didn’t follow up on time and refuse to take the adjuvant treatments. 8 patients were extremely satisfied with the treatment effect, and 2 patients were satisfied with the treatment effect.Conclusions:For medium and large-sized keloids in the trunk, combined modality therapy, including local perforator pedicled flaps transplantation, early radiotherapy, topical silicone gel, elastic compression and etc, will achieve satisfied clinical effects.
