Department of Plastic Surgery, The Christie Hospital, NHS Foundation Trust, Manchester, United Kingdom.
J Reconstr Microsurg. 2012 Oct;28(8):495-500. doi: 10.1055/s-0032-1315767. Epub 2012 Jun 28.
Reconstruction of complex head and neck cases involving bony and dural defects poses many issues. The primary aims of reconstruction are to provide a tight dural seal with good cranial support while also achieving a satisfactory cosmetic result.
This study describes the use of combined radial forearm cutaneous flap and radial forearm fascial flaps for reconstruction of complex skull defects where each component is used for a distinct reconstructive purpose. The benefits of this technique are illustrated in the cases of three patients requiring reconstruction following tumor resection.
The fascial component was used as a seal for dural defects. The cutaneous flap was then used to reconstruct the concomitant cutaneous defect.
The combined use of the fascial and cutaneous components of the radial forearm flap, where each is used for a distinct reconstructive purpose, increased the reconstructive versatility of this commonly used flap. The fascial flap was a thin, pliable, and highly vascularized piece of tissue that was effectively used to provide a watertight seal for the dural defect. The simultaneous use of the cutaneous flap gave support to the bony defect while providing a good cosmetic result.
涉及骨和硬脑膜缺损的复杂头颈部病例的重建存在诸多问题。重建的主要目的是在提供紧密的硬脑膜密封和良好的颅支撑的同时，实现令人满意的美容效果。
本研究描述了联合使用游离前臂皮瓣和游离前臂筋膜瓣来重建复杂的颅骨缺损，其中每个成分都用于特定的重建目的。该技术的优点在 3 例因肿瘤切除后需要重建的患者中得到了说明。
筋膜成分用于硬脑膜缺损的密封。然后使用皮瓣来重建伴随的皮肤缺损。
联合使用游离前臂皮瓣的筋膜和皮瓣成分，其中每个成分都用于特定的重建目的，增加了这种常用皮瓣的重建多功能性。筋膜瓣是一种薄而柔韧、高度血管化的组织，可有效地用于为硬脑膜缺损提供防水密封。同时使用皮瓣为骨缺损提供支撑，同时获得良好的美容效果。
