Scarpa's adipofascial flap for repair of wide scalp defects
Scarpa's adipofascial flap for repair of wide scalp defects
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DOI：
10.1097/00000637-199601000-00018
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发表时间：
1996-01-01
影响因子：
1.5
通讯作者：
Watanabe, A
中科院分区：
文献类型：
--
作者：
Koshima, I;Inagawa, K;Watanabe, A
斯卡帕筋膜是身体的一个突出的浅表筋膜系统，它由浅表脂肪层和深层脂肪层之间的单一膜组成，广泛分布于下腹壁。我们描述了一例因皮肤纤维肉瘤切除术而导致大面积头皮缺损的病例，并使用斯卡帕脂肪筋膜瓣（即脐旁穿孔为基础的脂肪筋膜瓣-腹股沟脂肪筋膜瓣联合）重建缺损。斯卡帕脂肪筋膜瓣治疗头皮缺损的主要优点是：(1)供体部位是最容易接受的自由皮瓣，供体疤痕最小，功能障碍最小；(2)即使采用大皮瓣，也可直接闭合供体缺损，无需植皮；(3)对于肥胖患者，由于腹壁的美容改善，这种皮瓣是优选的；(4)供区有许多穿支，这些穿支的组合可以获得延伸的脂肪筋膜瓣；和(5)皮瓣可以滋养动脉之一,如浅或深腹壁下动脉,或旋髂浅或深动脉,皮瓣的缺点是,香港用单一动脉可能小于皮瓣的动脉和oversurfacing贪污导致可怜的化妆造型,斯卡帕氏adipofascial皮瓣时显示缺陷的暴露面积,特别是孩子,年轻的病人,而女性，当这个过程与二次修复中的皮肤扩张方法相结合时。
Scarpa's fascia is a prominent superficial fascial system of the body, It consists of a single membrane between the superficial fatty layer and deep fatty layer, and lies widely in the lower abdominal wall, We describe a case with a wide scalp defect resulting from a resection of a dermatofibrosarcoma, and reconstruction of the defect with Scarpa's adipofascial flap (i.e., a combined paraumbilical perforator-based adipofascial flap-groin adipofascial flap). The primary advantage of Scarpa's adipofascial flap for scalp defects is that (1) the donor site is most acceptable for a free flap with a minimal donor scar and minimal dysfunction; (2) even in cases in which large flaps are used, donor defects can be closed directly without skin grafting; (3) in the obese patient, this flap is preferable because of cosmetic improvement of the abdominal wall; (4) the donor area has so many perforators that an extended adipofascial flap can be obtained with a combination of these perforators; and (5) the flap may be nourished with one of several arteries, such as the superficial or deep inferior epigastric artery, or the superficial or deep circumflex iliac artery, The disadvantages of this flap are that the territory with a single artery may be smaller than a skin flap with the same artery and oversurfacing of the graft results in a poor cosmetic appearance, Scarpa's adipofascial flap is indicated when the defects are in an exposed area, especially in children, young patients, and females, and when this procedure is combined with a skin-expanding method in the secondary repair.