Boahene Kofi, Richmon Jeremy, Byrne Patrick, Ishii Lisa
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline St, Sixth Floor, Johns Hopkins Outpatient Center, Baltimore, MD 21287, USA.
Arch Facial Plast Surg. 2011 Nov-Dec;13(6):392-4. doi: 10.1001/archfacial.2011.65.
To present a modified technique in the harvest and application of split-thickness skin graft (STSG) from the primary flap donor site in forearm fasciocutaneous free flaps.
A prospective review was performed on 16 consecutive patients who had undergone a radial forearm free flap procedure for reconstruction of head and neck defects with a hinged forearm STSG used to reconstruct the flap donor site defect.
Sixteen patients with a mean (SD) defect size of 53.7 (29.9) cm(2) underwent the hinged STSG procedure. A hinged STSG was successfully harvested from all patients without disruption. Graft take was greater than 90% in all patients by postoperative day 7. A secondary skin graft donor site was avoided in all but 2 patients. Good color match of the deepithelialized flap with surrounding oral and pharyngeal mucosa was observed. Visible scarring along the graft hinge margin was absent. No bridging scars resulted from the deepithelialized flaps.
The hinged STSG from the forearm is a reliable method of repairing radial forearm free flap donor site defects and offers the advantages of reduced suture line scarring, minimal STSG disruption, low or no secondary donor site morbidity, and good color match at the donor and recipient flap sites.
介绍一种改良技术，用于在前臂游离筋膜皮瓣的主要皮瓣供区获取和应用中厚皮片（STSG）。
对16例连续患者进行前瞻性研究，这些患者接受了桡侧前臂游离皮瓣手术，用于修复头颈部缺损，并用带蒂前臂STSG修复皮瓣供区缺损。
16例平均（标准差）缺损面积为53.7（29.9）cm²的患者接受了带蒂STSG手术。所有患者均成功获取带蒂STSG且未出现破裂。术后第7天所有患者的移植皮片成活率均超过90%。除2例患者外，均避免了二次皮片供区。观察到去上皮化皮瓣与周围口腔及咽黏膜颜色匹配良好。移植皮瓣铰链边缘未见明显瘢痕。去上皮化皮瓣未形成桥接瘢痕。
前臂带蒂STSG是修复桡侧前臂游离皮瓣供区缺损的可靠方法，具有减少缝线瘢痕、最小化STSG破裂、低或无二次供区并发症以及供区和受区皮瓣颜色匹配良好等优点。
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