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[应用持续负压治疗的个体化预制三维皮瓣重建头颈外科肿瘤所致缺损]

[Reconstruction of tumor induced defects in head and neck surgery with individualized prefabricated three dimensional flaps with the use of continuous vacuum therapy].

作者信息

Schipper J, Leffler M, Maier W, Kopp J, Bach A D, Horch R E

机构信息

Universitäts-HNO-Klinik Freiburg.

出版信息

Zentralbl Chir. 2006 Apr;131 Suppl 1:S141-5. doi: 10.1055/s-2006-921507.

Abstract

Despite recent developments in oncologic head and neck surgery extensive tissue and functional defects following radical tumor resections remains a surgical challenge. Individually prefabricated free flaps to meet the needs of the functional defect can be generated with the help of continuous computer-assisted vacuum therapy. This accelerates the pre-fabrication of three-dimensional composite flaps and enhances therapeutic safety. Changes of the genuine structure of such flaps are induced by implantation of autologous or heterologous transplants alone or in combination with alloplastic materials as a supportive element. Application of vacuum therapy is useful to accelerate the process of pre-fabrication by the induction of angiogenesis. Besides this the continuous removal of wound exudate, possible seroma or haematoma and secondary compression of the different tissue layers improve the modelling of the three-dimensional construct. This article describes the technique of vacuum therapy for the pre-fabrication of three-dimensional pedicled or free flaps for reconstruction of defects after tumor resection in the head and neck area.

摘要

尽管近年来头颈部肿瘤手术有了新进展,但根治性肿瘤切除术后广泛的组织和功能缺损仍是一项手术挑战。借助持续的计算机辅助真空治疗,可以制作出个体化的游离皮瓣,以满足功能缺损的需求。这加速了三维复合皮瓣的预制,并提高了治疗安全性。此类皮瓣的真实结构变化是通过单独植入自体或异体移植物,或与异种材料联合作为支撑元素来诱导产生的。应用真空治疗有助于通过诱导血管生成来加速预制过程。除此之外,持续清除伤口渗出物、可能出现的血清肿或血肿以及对不同组织层的二次压迫,可改善三维结构的塑形。本文描述了用于预制三维带蒂或游离皮瓣的真空治疗技术,该皮瓣用于头颈部肿瘤切除术后缺损的重建。

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