Abstract:

BACKGROUND: Axial myocutaneous flap transplantation is the common method for repair of various refractory. This method had certain blindness in judgment of the main arteries in flaps before surgery in the past. Therefore, it is important to develop a more accurate method.
OBJECTIVE: To introduce the application experiences of axial myocutaneous flap in repair of refractory wound in the cervico-thoracic region.
METHODS: Color doppler flow imaging was used to examine the starting point, branching point, exterior diameter, vessel trend, vessel length and hemodynamic parameters of the main arteries of 4 types flaps from 62 cases. The axial myocutaneous flaps were designed according to the detection. The sizes of the axial myocutaneous flaps ranged from (9 cm×7 cm) to (18 cm×13 cm).
RESULTS AND CONCLUSION: According to color doppler flow imaging, one case of thoracodorsal artery had slow blood flow, rough vascular wall and obvious arteriosclerosis, and the other cases were with smooth blood flow and vascular wall, and without embolism, arteriosclerosis or absence of blood vessel. The starting point, branching point, exterior diameter, vessel trend and anatomic layers of the detected arteries were displayed clearly, in consistency with the results of operation; the flap completely survived in 60 cases with primary healing; distal partial necrosis occurred in 2 cases and was cured by symptomatic treatment. All the cases were followed up for 4 weeks to 6 years, 24 months in average, and the flaps were with a normal color, good texture and satisfactory appearance. Choosing a suitable pedicled musculocutaneous flap for refractory wound in cervico-thoracic region according to specific conditions can achieve satisfactory function and appearance. Color doppler flow imaging is a simple, intuitive and and non-invasive method to judge blood vessels of axial myocutaneous flaps, and can guide the axial myocutaneous flap transplantation.