Department of Plastic Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, 329-0498 Tochigi, Japan.
J Craniomaxillofac Surg. 2012 Jan;40(1):61-6. doi: 10.1016/j.jcms.2011.01.017. Epub 2011 Feb 25.
"Bare bone graft" with a vascularised iliac crest is a procedure involving no soft tissue for intraoral lining, and the intraoral defect is covered with epithelial cells through secondary healing of the exposed bone.
A vascularised iliac crest flap is transferred to a segmental mandibular defect intraorally in the position of the osteotomized stump upwardly. Granulation tissue is usually observed on the stump of the bone graft about 1 week after surgery. When sufficient granulation is observed after approximately 4 weeks, "resurfacing" is performed to prevent interference of hypergranulation tissue with epithelization. Resurfacing involves wiping the granulation tissue from the surface of the bone and covering with a plastic prosthesis fitted to the alveolus.
A total of 11 patients underwent bare bone graft with a vascularised iliac crest. Resurfacing was performed at an average of 2.1 times for each patient. All wounds in the oral cavity were completely epithelialized from 2 weeks to 3 months after surgery. Complications with the recipient side occurred in four patients.
Bare bone graft with the iliac crest is one favourable option for mandibular reconstruction utilising the particular shape of the bone without the attached soft tissue.
“裸骨移植”伴血管化髂嵴是一种不涉及任何口腔内衬软组织的手术，口腔内的缺损通过暴露骨的二期愈合被上皮细胞覆盖。
将血管化的髂嵴皮瓣向上转移到颌骨节段性缺损的口腔内位置的截骨残端。术后约 1 周，通常可在骨移植残端观察到肉芽组织。大约 4 周后观察到足够的肉芽组织后，进行“表面处理”以防止过度肉芽组织干扰上皮化。表面处理涉及从骨表面擦拭肉芽组织并用适合牙槽的塑料假体覆盖。
共有 11 例患者接受了带血管化髂嵴的裸骨移植。每位患者平均进行了 2.1 次表面处理。术后 2 周到 3 个月，所有口腔内的伤口均完全上皮化。4 例患者出现受区并发症。
利用髂嵴的特殊形状而不附着软组织的裸骨移植是一种有利于下颌骨重建的选择。
