Langstein Howard N, Robb Geoffrey L
Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Clin Plast Surg. 2005 Jul;32(3):431-45, viii. doi: 10.1016/j.cps.2005.02.007.
For defects up to approximately 80% of either upper or lower lip, reconstructions that use remaining lip and cheek can function and look reasonably well. Free tissue transfers, such as the free radial forearm flap, are useful for larger defects as they import additional tissue in one step and reduce microstomia, which is more likely to result from local tissue repairs. At best, free flaps provide a static dam or curtain that functions as a lip; at worst, they deliver a large amount of composite tissue to allow for primary healing. Satisfactory outcomes after free flap reconstructions for lip are best achieved when the transferred tissue is integrated with the native tissues by suspending free flaps appropriately, resurfacing with the flaps with vermilion substitutes, and judicious interposition of remaining lip segments.
对于上唇或下唇缺损达约80%的情况，利用剩余唇部和面颊进行的重建在功能和外观上可达到较为理想的效果。游离组织移植，如游离桡侧前臂皮瓣，对于较大缺损很有用，因为它们可一次性引入额外组织并减少小口畸形，小口畸形更可能由局部组织修复导致。游离皮瓣充其量能提供一个起到唇部作用的静态屏障或帘子；最糟的情况是，它们提供大量复合组织以实现一期愈合。当通过适当悬吊游离皮瓣、用朱红色替代物覆盖皮瓣以及明智地插入剩余唇部节段，使移植组织与天然组织整合时，游离皮瓣重建唇部后最易获得满意效果。
