采用局部网状全厚皮片移植闭合桡侧前臂游离皮瓣供区缺损：一项原创技术的回顾性研究
Closure of radial forearm free flap donor site defect with a local meshed full-thickness skin graft: a retrospective study of an original technique.
作者信息
Karimi Abbas, Mahy Pierre, Reychler Hervé
机构信息
Department of Oral and Maxillofacial Surgery, University Hospital Saint-Luc, Catholic University of Louvain, Brussels, Belgium.
出版信息
J Craniomaxillofac Surg. 2007 Dec;35(8):369-73. doi: 10.1016/j.jcms.2007.07.004. Epub 2007 Nov 26.
INTRODUCTION
Closure of the radial free flap donor site remains a problem. Donor site morbidity is related to poor skin graft taking, inaesthetic appearance and hand sensory dysfunction.
PATIENTS AND METHODS
From January 1998 to December 2002, 41 radial free flaps were harvested. The donor site closure technique consisted of a combination of: flexor tendons coverage, purse string and local meshed full-thickness skin graft.
RESULTS
The mean time of wound healing of the donor site was 4.68 weeks. Four patients (16%) developed a partial necrosis of the skin graft. Nine patients (36%) showed a definitive hypoaesthesia in the dorsal region of the thumb. Neither total necrosis of the skin graft nor exposure of flexor carpi radialis tendon was noted. The average visual analogue scale of the aesthetics was 6 (patients), 4.18 (students) and 7.2 (first author) out of 10.
CONCLUSION
This technique for closing a small-to-medium sized radial donor site defect is recommended.
引言
桡侧游离皮瓣供区的闭合仍然是一个问题。供区并发症与皮片移植效果不佳、外观不美观以及手部感觉功能障碍有关。
患者与方法
1998年1月至2002年12月，共采集了41例桡侧游离皮瓣。供区闭合技术包括以下方法的联合应用：屈肌腱覆盖、荷包缝合和局部网状全厚皮片移植。
结果
供区伤口愈合的平均时间为4.68周。4例患者（16%）出现皮片部分坏死。9例患者（36%）在拇指背侧区域出现明确的感觉减退。未发现皮片完全坏死或桡侧腕屈肌腱外露的情况。美学方面的平均视觉模拟评分在10分制中，患者为6分，学生为4.18分，第一作者为7.2分。
结论
推荐采用这种技术来闭合中小面积的桡侧供区缺损。
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