Freedman A M, Hidalgo D A
Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Ann Plast Surg. 1990 Oct;25(4):287-94. doi: 10.1097/00000637-199010000-00008.
The radial forearm free flap has proven versatility in head and neck reconstruction. It is superior to regional alternatives such as the pectoralis flap because it is thin, pliable, and predominantly hairless. A more recent application is the use of the folded forearm flap to replace both the skin and inner lining, simultaneously, in full-thickness cheek and lip defects. Nine such cases are presented in this report. Each patient had a recurrent lesion that had been reconstructed previously with local flaps, and all but one were treated with postoperative radiation therapy. The average size of the external defects after resection was 27 cm2, and of the intraoral defects, 18 cm2. All free flaps survived completely. The folded forearm flap solved the reconstructive problem for each patient in a single-stage procedure, providing good contour and a reasonable color match. The flap is easy to raise, has a long pedicle with large-diameter vessels, and has an acceptable donor site defect not associated with long-term morbidity.
桡侧前臂游离皮瓣在头颈部重建中已证明具有多功能性。它优于胸大肌皮瓣等局部替代皮瓣，因为它薄、柔韧且基本无毛。最近的一种应用是使用折叠前臂皮瓣同时替代全层颊部和唇部缺损的皮肤和内衬。本报告介绍了9例此类病例。每位患者均有复发性病变，之前已用局部皮瓣进行重建，除1例患者外，其余均接受了术后放射治疗。切除后外部缺损的平均面积为27平方厘米，口腔内缺损的平均面积为18平方厘米。所有游离皮瓣均完全存活。折叠前臂皮瓣通过单阶段手术解决了每位患者的重建问题，提供了良好的外形和合理的颜色匹配。该皮瓣易于切取，有带大口径血管的长蒂，供区缺损可接受，且无长期并发症。
