Lutz B S, Chang S C, Chuang S S, Wei F C
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Medical College & Chang Gung University, Taipeh, Taiwan.
Handchir Mikrochir Plast Chir. 1999 Jan;31(1):10-4. doi: 10.1055/s-1999-13899.
From March 1995 to May 1997, 66 free radial forearm flaps were used for orofacial reconstructions. All flaps were elevated following the suprafascial technique. Donor-site closure was performed with split-thickness skin grafts in 54 cases, and with full-thickness skin grafts in 12 patients. Investigations after six months included grip strength, pulp-to-pulp pinch strength, range of motion as compared to preoperative values, aesthetical self-assessment, cold intolerance, and dysesthesias. The latter evaluation could be performed in 42 patients, whereas the complete follow-up protocol included 36 patients. Primary wound healing with immediate complete take of skin grafts was achieved in 93.9%. Grip strength and pulp-to-pulp pinch strength showed no decrease postoperatively. An impairment of range of motion of the wrist was observed in 2.8%. There was no cold intolerance. Aesthetical outcome was rated as good or fair in 97.3%. Slight numbness distally to the donor-site was found in 59.5%. The results of this prospective study show a superiority of suprafascial elevation of the radial foream flap as compared to the classic elevation technique, particularly in a higher rate of primary wound healing, thus avoiding impairment of range of motion and strength of the donor hand.
1995年3月至1997年5月，66例患者采用游离桡侧前臂皮瓣进行口腔颌面修复。所有皮瓣均采用筋膜上技术掀起。54例患者的供区采用中厚皮片封闭，12例患者采用全厚皮片封闭。术后6个月的检查包括握力、指尖对指尖捏力、与术前值相比的活动范围、美学自我评估、冷不耐受和感觉异常。42例患者可进行后者的评估，而完整的随访方案包括36例患者。93.9%的患者实现了一期伤口愈合，皮片立即完全成活。握力和指尖对指尖捏力术后无下降。2.8%的患者观察到腕关节活动范围受损。无冷不耐受情况。97.3%的患者美学效果评为良好或尚可。59.5%的患者供区远端有轻微麻木。这项前瞻性研究的结果表明，与经典掀起技术相比，桡侧前臂皮瓣筋膜上掀起具有优越性，尤其是在一期伤口愈合率更高方面，从而避免了供手活动范围和力量的受损。
