Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chia Yi, Taiwan.
J Reconstr Microsurg. 2013 May;29(4):263-70. doi: 10.1055/s-0032-1333320. Epub 2013 Jan 21.
Perforator flap transfer has the benefits of minimal donor site morbidity and customization in design. This study reports on the proximal lateral leg perforator (PLLP) flap transfer for head and neck reconstruction.
From January 2000 through December 2009, 18 patients underwent head and neck reconstruction with the PLLP flap, including 16 males and 2 females ranging in age between 32 and 80 years old. The mean follow-up time was 9.8 months.
Mother vessels of PLLP flaps can arise 77.8% (14/18) from the peroneal system, 11.1% (2/18) from the posterior tibial system, or 11.1% (2/18) from the common popliteal system. The skin dimension ranges from 4 cm × 7 cm to 6.5 cm × 18 cm. The mean of the perforator size is 1.96 mm (1.5 mm to 2.3 mm). The mean of the pedicle length is 6.96 cm (4.5 cm to 10 cm). All flaps survived completely except one flap that had partial necrosis.
The PLLP flap for head and neck reconstruction offers versatility in design, diverse tissues for composition, a two-team approach, and negligible donor site morbidity, and it spares major vessels. The unpredictable pedicle length and the feasibility for microvascular anastomosis in the perforator level can be adapted with further experience and refining techniques.
穿支皮瓣转移具有供区并发症少和设计可定制化的优点。本研究报告了用于头颈部重建的近端外侧小腿穿支皮瓣(PLLP)转移。
2000 年 1 月至 2009 年 12 月,18 例患者接受了 PLLP 皮瓣的头颈部重建,包括 16 名男性和 2 名女性,年龄在 32 至 80 岁之间。平均随访时间为 9.8 个月。
PLLP 皮瓣的母血管可来源于腓动脉系统的 77.8%(14/18)、胫后动脉系统的 11.1%(2/18)或腘动脉系统的 11.1%(2/18)。皮瓣的大小范围为 4 cm×7 cm 至 6.5 cm×18 cm。穿支的平均直径为 1.96mm(1.5mm 至 2.3mm)。蒂的平均长度为 6.96cm(4.5cm 至 10cm)。除 1 例皮瓣部分坏死外,所有皮瓣均完全存活。
用于头颈部重建的 PLLP 皮瓣在设计上具有多样性,可包含多种组织,可采用双团队方法,供区并发症少,可避免主要血管损伤。穿支蒂的不可预测的长度和在穿支水平进行吻合的可行性可通过进一步的经验和改进技术来适应。