Wang Hui-Yong, Li Qing-Feng, Zheng Sheng-wu, Li Yu-ping, Tang Lu-jia, Zhang Di-sheng
Department of plastic and Reconstructive Surgery, the Ninth People' s Hospital, Shanghai Second Medical University, Shanghai 200011, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2006 Sep;22(5):331-3.
To explore the operational strategy of harvesting total facial allograft by autopsy.
Twelve fresh human cadavers were dissected. They were divided into two groups randomly. The total facial-scalp flap of the group I was elevated by the bi-pedicle method, the group II was operated with single-pedicle method. Both were dissected at the deep plane of the SMAS. : the time of facial flap harvesting, length of the artery vein and nerve pedicles of the donor were measured and marked, after operation, in each group we transferred one facial allograft to another. Then the free graft of group I was poured through artery by methylthioninium chloride to study vascular territories.
Mean harvesting time of the group I (46 +/- 11) minutes, group II (111 +/- 7) minutes, P < 0.01. Perfusion result shows that unilateral superficial temporal artery and the opposite side of the facial artery can supply blood for whole face. The pedicle was long enough for anastomosis. Post-operation appearance: the face looks like neither the donor nor the recipient primarily, It's mainly due to the characteristics of the skeleton and the soft tissues.
The bi-pedicle method of the harvesting total facial allograft is concise, fast, safe can be widely applied in clinical.
探讨通过尸检获取全颜面同种异体组织的手术策略。
解剖12具新鲜人体尸体。随机分为两组。I组采用双蒂法掀起全颜面-头皮瓣,II组采用单蒂法手术。均在SMAS深层平面进行解剖:测量并标记供体颜面瓣获取时间、动静脉及神经蒂长度,术后在每组内将一个颜面同种异体组织移植至另一个。然后经I组游离移植物的动脉注入亚甲蓝以研究血管分布区域。
I组平均获取时间(46±11)分钟,II组(111±7)分钟,P<0.01。灌注结果显示,单侧颞浅动脉及对侧面动脉可为全脸供血。蒂长足以进行吻合。术后外观:面部最初既不像供体也不像受体,这主要是由于骨骼和软组织的特点。
全颜面同种异体组织获取的双蒂法简洁、快速、安全,可在临床上广泛应用。