Woodworth Bradford A, Gillespie M Boyd, Day Terry, Kline Richard M
Department of Otolaryngology/Head and Neck Surgery, 135 Rutledge Ave., Suite 1130, PO Box 250550, Medical University of South Carolina, Charleston, SC 29425, USA.
Head Neck. 2006 Sep;28(9):802-7. doi: 10.1002/hed.20393.
Our aim in this retrospective case series was to review the indications, results, and complications of abdominal muscle-sparing free flaps in head and neck cancer reconstruction.
A retrospective review of all head and neck cancer defects reconstructed with abdominal muscle-sparing free tissue transfers from 1999 to 2004 was performed. Data collected included patient demographics, etiology and site of the defect, reconstructive technique, flap size, recipient vessels, complications, reconstructive technique, and clinical follow-up.
Sixteen patients underwent reconstruction with the deep inferior epigastric perforator (DIEP) flap (n = 11), the superficial inferior epigastric artery (SIEA) flap (n = 4), or the superficial circumflex iliac artery (SCIA) flap (n = 1). Average age was 61 years (range, 41-77 years). The average hospital stay was 7.6 days (range, 6-14 days). The average defect size was 74.5 cm(2) (range, 30-240 cm(2)). No subsequent abdominal wall hernias or other donor site complications occurred after a mean follow-up of 21 months.
Muscle-sparing abdominal free flaps are attractive options for head and neck cancer reconstruction. The SIEA and SCIA free flaps have the distinct advantage of eliminating abdominal hernias and other morbidity related to the excision of rectus abdominus fascia or muscle. In addition, the incisions are very low on the abdomen and are more cosmetically pleasing to the patient.
在这个回顾性病例系列中，我们的目的是回顾保留腹直肌游离皮瓣在头颈癌重建中的适应证、结果及并发症。
对1999年至2004年期间采用保留腹直肌游离组织移植修复的所有头颈癌缺损进行回顾性研究。收集的数据包括患者人口统计学资料、缺损的病因和部位、重建技术、皮瓣大小、受区血管、并发症、重建技术及临床随访情况。
16例患者接受了腹壁下深动脉穿支（DIEP）皮瓣（n = 11）、腹壁下浅动脉（SIEA）皮瓣（n = 4）或旋髂浅动脉（SCIA）皮瓣（n = 1）重建。平均年龄为61岁（范围41 - 77岁）。平均住院时间为7.6天（范围6 - 14天）。平均缺损面积为74.5平方厘米（范围30 - 240平方厘米）。平均随访21个月后，未发生腹壁疝或其他供区并发症。
保留腹直肌的腹部游离皮瓣是头颈癌重建的理想选择。SIEA和SCIA游离皮瓣具有消除腹壁疝及其他与腹直肌筋膜或肌肉切除相关并发症的显著优势。此外，腹部切口位置很低，对患者来说美容效果更佳。
