Peña Ignacio, de Villalaín Lucas, García Eva, Junquera Luis Manuel, de Vicente Juan Carlos
Department of Oral and Maxillofacial Surgery, Central University Hospital of Asturias, Oviedo, Asturias, Spain.
J Oral Maxillofac Surg. 2012 Oct;70(10):2453-8. doi: 10.1016/j.joms.2011.10.028. Epub 2012 Jan 21.
The radial forearm flap is one of the most commonly used methods for intraoral reconstruction in oral carcinoma surgery. One of its disadvantages is the residual functional and unaesthetic defect in the donor site. The objective of this report is to describe preliminary cases of a novel method to cover such donor sites based on the use of autologous skin equivalents (ASEs) and an artificial dermal matrix (Integra, Prim, Barcelona, Spain).
The donor sites of 2 patients were treated with the artificial dermal matrix after raising a radial forearm flap. A skin biopsy and a blood sample were taken to construct an ASE. After 3 weeks, the ASE was applied over the dermal template and left to heal. The functional and esthetic results were recorded.
Good functional and esthetic results were achieved, with correct wrist motility, although a natural skin color could not be achieved. Neither the Integra nor the ASE was rejected. Total wound coverage was achieved at 4 months, and completely normal skin was observed at 6 months.
This technique of combining an artificial dermal matrix with an ASE could be an alternative method to cover the donor sites of radial forearm flaps.
桡侧前臂皮瓣是口腔癌手术中最常用的口腔内重建方法之一。其缺点之一是供区存在功能和美观方面的残留缺陷。本报告的目的是描述基于使用自体皮肤替代物（ASEs）和人工真皮基质（Integra，Prim，巴塞罗那，西班牙）覆盖此类供区的一种新方法的初步病例。
2例患者在切取桡侧前臂皮瓣后，用人工真皮基质处理供区。取皮肤活检组织和血样构建ASE。3周后，将ASE覆盖在真皮模板上并任其愈合。记录功能和美学效果。
获得了良好的功能和美学效果，腕关节活动正常，尽管未能实现自然肤色。Integra和ASE均未被排斥。4个月时实现了创面完全覆盖，6个月时观察到皮肤完全正常。
这种将人工真皮基质与ASE相结合的技术可能是覆盖桡侧前臂皮瓣供区的一种替代方法。
