측두두정근막과 견갑부근막 유리피판의 조직학적 및 임상적 고찰

A Histologic and Clinical Study between Temporoparietal Fascia and Scapular Fascia Free Flap

  • 강양수 (조선대학교 의과대학 성형외과학교실) ;
  • 천지선 (조선대학교 의과대학 성형외과학교실) ;
  • 나영천 (조선대학교 의과대학 성형외과학교실) ;
  • 이명주 (조선대학교 의과대학 성형외과학교실) ;
  • 양정열 (조선대학교 의과대학 성형외과학교실) ;
  • 이창근 (조선대학교 의과대학 성형외과학교실)
  • Kang, Yang Soo (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Cheon, Ji Seon (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Na, Young Cheon (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Lee, Myung Ju (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Yang, Jeong Yeol (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University) ;
  • Lee, Chang Keun (Department of Plastic and Reconstructive Surgery, College of Medicine, Chosun University)
  • 발행 : 2000.10.31

초록

Fascia and fasciocutaneous free flaps (using perforators) are adequate reconstructive options with aesthetic and functional advantages, particularly for reconstruction of variable soft tissue defects of the extremities. Although various donor sites have been used for these concerns including temporoparietal fascia, serratus fascia, scapular fascia, fascial component of lateral arm and posterior calf fascia. The authors used temporoparietal and scapular fascia as a free flap for coverage of soft tissue defects and we compare two flap mainly their histologic studies and clinical applications. In our expierience both fascia provide thin, pliable coverage for exposed bone and tendons and provide good postoperative functional restoration on the recipient area. Histologically temporoparietal fascia flap has more rich blood supply and scapular fascia flap is rich in adipose tissue in their composition. In donor site morbidity, both flaps can bring satisfactory results about the donor sites, but the donor site of the temporoparietal fascia flap sometimes revealed conspicious linear scar and transient alopecia in short-haired patients and the scapular fascia flap has a tendency to be wider and thicker in obese patients. After successful application of the both fascia flap as a free flap in 38 patients (25 temporoparietal fascia, 13 scapular fascia) since 1995 ; authors recommend using the temporoparietal fascia flap for women, who tend to have more fat and longer hair, and the scapular fascia flap for men, who tend to be leand & shorter hair.

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