Department of Otolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland.
Ir J Med Sci. 2010 Sep;179(3):337-43. doi: 10.1007/s11845-010-0468-4. Epub 2010 Feb 12.
With the advent of microsurgery the pedicled flap is considered by many to be an outdated surgical option.
To explore the relationship between flap survival and pre-morbid risk factors, conduct a comparative analysis of flap and systemic morbidities and complete a cosmesis and functionality assessment for oral and oropharyngeal reconstruction patients.
114 patients, over a 13-year period, who had a one-stage reconstructive procedure employing the pectoralis major myocutaneous flap (PMMF) or radial forearm-free flap (RFFF).
Variables, including age, smoking and radiation exposure were not statistically significant predictors of flap survival probability. Atelectasis was a significant post-op finding of RFFF patients. Flap dehiscence of >50% was a significant morbidity of PMMF. No statistical difference in cosmetic deformity, diet and socialisation was noted.
Pectoralis major myocutaneous flap remains an enduring and safe flap; however, the RFFF has markedly improved speech performance over the PMMF.
随着显微外科的出现，带蒂皮瓣被许多人认为是一种过时的手术选择。
探讨皮瓣存活与术前危险因素的关系，对皮瓣和全身并发症进行对比分析，并对口腔和口咽重建患者的美容和功能进行评估。
对 114 例患者进行了为期 13 年的研究，采用胸大肌肌皮瓣（PMMF）或游离桡动脉皮瓣（RFFF）进行一期重建。
年龄、吸烟和辐射暴露等变量并不是皮瓣存活率的统计学显著预测因素。RFFF 患者术后出现肺不张。PMMF 的皮瓣裂开>50%是一种显著的并发症。在美容畸形、饮食和社交方面没有发现统计学差异。
胸大肌肌皮瓣仍然是一种持久和安全的皮瓣；然而，与 PMMF 相比，RFFF 明显提高了患者的言语功能。
