Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
J Plast Reconstr Aesthet Surg. 2013 Mar;66(3):372-5. doi: 10.1016/j.bjps.2012.10.003. Epub 2012 Oct 25.
The fibular flap and the scapular flap are widely used for immediate reconstruction after segmental mandibulectomy. The aim of this study was to compare perioperative complications between the fibular flap and the scapular flap in immediate mandibular reconstruction.
Data were retrospectively collected on 56 patients who had undergone immediate mandibular reconstruction with a fibular flap (38 patients) or a scapular flap (18 patients) after segmental mandibulectomy from 2005 to 2011. The rates of perioperative recipient-site and donor-site complications were compared between the groups.
The overall rate of recipient-site complications did not differ significantly between the fibula group and the scapula flap. However, the rate of donor-site complications was significantly higher in the fibula group than in the scapula group. Partial skin-graft loss in the fibula group occurred in as high as 13 out of 38 patients.
For immediate mandibular reconstruction, a scapular flap provides short-term results equivalent to those with a fibular flap but with less donor-site morbidity. The major drawbacks of the fibular flap include prolonged healing of the donor site and the delayed mobilisation of patients. Although our first choice of vascularised bone graft is the fibular flap, the scapular flap in an alternative for those patients, especially elderly patients, in whom fibula harvest can result in significant morbidity.
游离腓骨瓣和游离肩胛骨瓣被广泛应用于下颌骨节段切除术后的即刻重建。本研究旨在比较游离腓骨瓣和游离肩胛骨瓣在下颌骨即刻重建中的围手术期并发症。
回顾性收集了 2005 年至 2011 年间 56 例行游离腓骨瓣（38 例）或游离肩胛骨瓣（18 例）即刻下颌骨重建术的患者资料。比较两组患者的受区和供区并发症发生率。
游离腓骨瓣组和游离肩胛骨瓣组的受区并发症总发生率无显著差异。然而，游离腓骨瓣组的供区并发症发生率显著高于游离肩胛骨瓣组。腓骨组有 13 例患者发生部分皮片坏死。
对于即刻下颌骨重建，游离肩胛骨瓣提供的短期效果与游离腓骨瓣相当，但供区并发症发生率较低。游离腓骨瓣的主要缺点是供区愈合时间延长和患者活动延迟。虽然我们首选的带血管骨移植是游离腓骨瓣，但对于那些腓骨采集可能导致严重并发症的患者，特别是老年患者，游离肩胛骨瓣是一种替代选择。
