Chang Kao-Ping, Lee Hsiao-Chen, Lai Chung-Sheng, Lin Sin-Daw
Department of Surgery, Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Head Neck. 2007 Apr;29(4):412-5. doi: 10.1002/hed.20508.
Autologous vein grafts are a valuable tool in microsurgical free tissue transfer. Interposition vein grafts offer the surgeon greater freedom when placing the free flap and choosing the recipient vessels, providing valuable options in case recipient vessels are not available for those patients with large wounds. Free flaps transferred to head and neck regions carry a higher risk of failure, which may be expected to increase more with the use of vein grafts.
We present our case with the double use of a single vein graft for both primary arterial conduit in end-to-end fashion and secondary end-to-side recipient site in the microsurgical reconstruction of a complicated head and neck defect.
All these anastomoses and flaps survived perfectly, and the patient was discharged 14 days after the transfer of the second flap.
Although the anastomosis of 2 flaps to a single vein graft was successful in our case, it represents a higher risk option than different recipient vessels. We provide this alternative procedure in selected patients, as there is no other receipt vessel or recipient blood flow strong enough to supply more than 1 flap.
自体静脉移植物是显微外科游离组织移植中的一种重要工具。插入式静脉移植物在放置游离皮瓣和选择受区血管时为外科医生提供了更大的灵活性,对于那些伤口较大且无法获得合适受区血管的患者而言,提供了有价值的选择。移植到头颈部区域的游离皮瓣失败风险更高,使用静脉移植物时预计这种风险会进一步增加。
我们报告了一个病例,在对头颈部复杂缺损进行显微外科重建时,一根静脉移植物同时以端对端方式用作主要动脉管道和端侧吻合的次要受区部位。
所有这些吻合口和皮瓣均完美存活,患者在第二个皮瓣移植后14天出院。
虽然在我们的病例中,将两个皮瓣吻合到一根静脉移植物上是成功的,但这比使用不同的受区血管风险更高。我们在特定患者中提供这种替代手术方法,因为没有其他足够强大的受区血管或受区血流来供应多个皮瓣。