[Application of island myocutaneous flap for refractory wound in cervico-thoracic region]

To introduce experiences in the application of island myocutaneous flap for refractory wound in cervico-thoracic region.

From August 1994 to December 2004, 98 cases of refractory wound in cervico-thoracic region were treated; there 42 males and 56 females, aging 21-68 years. The course of disease was 3 hours to 13 months. The locations were anterior pectorial region(29 cases), cervical part (28 cases), nuchal region (18 cases), subaxillary and axillary region (15 cases), and thoracic wall (8 cases). The defect area ranged from 6 cm x 4 cm to 20 cm x 15 cm. According to location, peculiarity and etiological factor of wound, various island myocutaneous flaps were selected: 28 pectoralis major island myocutaneous flaps, 34 latissimus dorsi island myocutaneous flaps, 19 trapizius island myocutaneous flaps and 17 rectus abdominis island myocutaneous flap. The sizes of the dissected flap ranged from 8 cm x 6 cm to 35 cm x 15 cm.

Of 98 patients, the wound healed by first intention and the flap survived completely in 92 and the flap necrosed partially in 6. The good function and cosmetic results were obtained without severe complication. Eighty-three cases were followed up from 2 weeks to 5 years. The flap obtained satisfactory appearance, good function and cosmetic results.

Repairing refractory wound in cervico-nuchal region may select pectoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap, and trapizius island myocutaneous flap; repairing refractory wound on thoracic region may select latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. According to specific condition of wound, using suitable island myocutaneous flap for refractory wound in cervico-thoracic region may obtain satisfactory functional and cosmetic results.