Lee Jong-Wook, Jang Young-Chul, Oh Suk-Joon
Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea.
Ann Plast Surg. 2005 Nov;55(5):500-2. doi: 10.1097/01.sap.0000183789.00146.c6.
The radial forearm free flap has been popular in many area of reconstructive surgery. Despite the many attributes of this flap in surgical reconstruction, one of the clear disadvantages has been the morbidity of the donor site. To solve problems associated with closure of the radial forearm flap donor site, the artificial dermis was used for better outcome in the donor site. From July of 2001 to October 2003, 13 patients (12 male, 1 female) ranging in age from 27 to 67 years underwent free radial forearm transfers. Flap size measured 49 to 144 cm2. Donor-site defects secondary to the flap elevation was closed first with the artificial dermis (Terudermis), marketed by Terumo Inc, Japan, and secondary split-thickness skin graft to the artificial dermis was performed in 15 days (range, 13 to 17 days) on average. There was no flap failure in all cases. Partial loss of the artificial dermis graft was noticed in 2 cases, but it was negligible. Secondary skin graft take was noticed in about 7 days, and there was no remarkable skin graft loss. The artificial dermis was used successfully in 13 patients with the donor defects of free radial forearm flap. Despite the disadvantage to need the secondary split-thickness skin graft, use of the artificial dermis gave us not only soft-tissue augmentation and graft-skin quality similar to full-thickness skin graft but also fast graft healing and diminished morbidity of the skin-graft donor site.
桡侧前臂游离皮瓣在许多重建外科领域都很受欢迎。尽管该皮瓣在手术重建中有诸多优点,但一个明显的缺点是供区并发症。为了解决与桡侧前臂皮瓣供区闭合相关的问题,采用人工真皮以改善供区效果。2001年7月至2003年10月,13例患者(男12例,女1例),年龄27至67岁,接受了桡侧前臂游离移植。皮瓣面积为49至144平方厘米。皮瓣掀起后供区缺损首先用日本泰尔茂公司生产的人工真皮(泰德真皮)闭合,平均15天(13至17天)后对人工真皮进行二期中厚皮片移植。所有病例均未出现皮瓣坏死。2例出现人工真皮移植部分丢失,但可忽略不计。二期植皮约7天成活,未出现明显植皮丢失。人工真皮成功应用于13例桡侧前臂游离皮瓣供区缺损患者。尽管需要二期中厚皮片移植有缺点,但使用人工真皮不仅能增加软组织厚度、提供与全厚皮片相似的植皮质量,还能加快植皮愈合、减少植皮供区并发症。