Peek A, Exner K
Klinik für Plastische- und Wiederherstellungschirurgie, Markus-Krankenhaus, Wilhelm-Epstein-Strasse 2, 60431 Frankfurt.
Kongressbd Dtsch Ges Chir Kongr. 2001;118:535-9.
Although regional flaps are the first choice for face reconstructions, large defects require tissue transfer from other parts of the body. Pedicled musculocutaneous flaps or free flaps are then the choice. Retrospective analysis of our cases of 42 pedicled and 58 free flaps between 1990 and 1999 showed a lower complication rate for free flaps. Moreover, free flaps offer the possibility of choosing from a variety of flap types, including thin fasciocutaneous perforator flaps, bulky musculocutaneous flaps and composite flaps with vascularized bone. Complex reconstructions of the face may require chimera and prefabricated flaps. Our choice then is the scapular region, where the subscapular vessels can carry independent tissue blocks of skin, bone and muscle. We demonstrate the reconstruction of the nose, palate and alveolar crest of the maxilla with such a prefabricated chimera flap.
尽管局部皮瓣是面部重建的首选，但大面积缺损需要从身体其他部位转移组织。带蒂肌皮瓣或游离皮瓣则是选择。对我们1990年至1999年间42例带蒂皮瓣和58例游离皮瓣病例的回顾性分析显示，游离皮瓣的并发症发生率较低。此外，游离皮瓣提供了从多种皮瓣类型中选择的可能性，包括薄型筋膜皮穿支皮瓣、厚实的肌皮瓣和带血管化骨的复合皮瓣。面部的复杂重建可能需要嵌合体皮瓣和预制皮瓣。我们的选择是肩胛区，肩胛下血管可以携带独立的皮肤、骨骼和肌肉组织块。我们展示了用这种预制嵌合体皮瓣对上颌骨的鼻、腭和牙槽嵴进行重建。
