| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to surgery and can be applied for reconstruction of soft tissue defect with free flap of serratus anterior. Traction frame is assembled and placed on skin in such way that its centre coincides with place of transaction with line drawn through nipples and anterior edge of latissimus dorsi. Frame is sewn with 5-6 thick threads to skin and subcutaneous fat, and tension mechanism with adjustable strength of travel is connected to frame. Gradual elevation of skin is carried out. 5-6 cm long cut is made in the centre of frame, in projection of place of thoracodorsal artery entrance into latissimus dorsi orienting cut line along anterior edge of latissimus dorsi. Skin, subcutaneous fat are dissected to fibres of latissimus dorsi. Anterior edge of latissimus dorsi is separated 3-4 cm farther than superior and inferior frame edges. Thoracodorsal artery and its branches are exposed to scapula angle and serratus anterior. Thoracodorsal artery and commitant veins are ligated after origin of serratus branch. Inferior teeth of muscle vascularised with branch of thoracodorsal artery to serratus anterior are determined. Muscular part of monoflap is cut out on periphery, intramuscular vascular branches being clipped. Final flap mobilisation is carried out and flap is pulled out through the main portal. Monoflap is used to replace defect of reconstructed skin. ^ EFFECT: method allows to reduce trauma for donor area, reduce risk of edge necroses. ^ 1 ex, 34 dwg |
