Ng Raymond W M, Chan Jimmy Y W, Mok Vivian, Leung Mark S C, Yuen Anthony P W, Wei William I
Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Laryngoscope. 2008 Apr;118(4):585-8. doi: 10.1097/MLG.0b013e31816067a3.
To evaluate anterolateral thigh flap shrinkage after elevation and to develop a predictive model for flap design.
A prospective study was conducted in a university teaching hospital. The skin islands from anterolateral thigh flaps were outlined on a transparent sheet before and after the reconstruction procedure. Dimensions of the stretched flaps were also recorded. These three outlines were scanned and the surface areas computed and compared by tracing and use of AutoCAD. Age, sex, flap dimension, and flap thickness were investigated for association with flap shrinkage.
Forty-five anterolateral thigh flaps harvested for head and neck soft tissue reconstruction after tumor resection were studied. Flap size ranged from 4 to 14 cm in width and 8 to 22 cm in length; flap area ranged from 30.6 to 151.0 cm. On average, the flaps shrunk by 25.0% (6.2%-52.6%), a highly significant change (P < .01). Flap width and thickness correlated with the reduction in flap size. The average stretched-flap area was 10.1% (0.4%-29.4%) less than the preflap area, a significant reduction (P < .01). The difference between stretched-flap and preflap areas was independent of all variables. We developed a predictive model using a stepwise multiple linear regression method with a coefficient of determination of 0.495.
Anterolateral thigh flaps shrink after harvesting, and flap width and thickness are significant contributing variables. These findings indicate that flap size must take shrinkage into account to ensure sufficient coverage.
评估股前外侧皮瓣切取后的收缩情况，并建立皮瓣设计的预测模型。
在一所大学教学医院进行一项前瞻性研究。在重建手术前后，将股前外侧皮瓣的皮岛轮廓描绘在一张透明纸上。记录伸展后皮瓣的尺寸。对这三个轮廓进行扫描，并通过追踪和使用AutoCAD计算和比较表面积。研究年龄、性别、皮瓣尺寸和皮瓣厚度与皮瓣收缩的相关性。
对45例用于肿瘤切除术后头颈部软组织重建的股前外侧皮瓣进行了研究。皮瓣宽度为4至14厘米，长度为8至22厘米；皮瓣面积为30.6至151.0平方厘米。平均而言，皮瓣收缩了25.0%（6.2%-52.6%），这是一个高度显著的变化（P <.01）。皮瓣宽度和厚度与皮瓣尺寸的减小相关。伸展后皮瓣的平均面积比皮瓣术前面积小10.1%（0.4%-29.4%），差异有统计学意义（P <.01）。伸展后皮瓣与术前皮瓣面积的差异与所有变量无关。我们使用逐步多元线性回归方法建立了一个预测模型，决定系数为0.495。
股前外侧皮瓣切取后会收缩，皮瓣宽度和厚度是显著的影响变量。这些发现表明，在设计皮瓣尺寸时必须考虑到收缩情况，以确保有足够的覆盖面积。
