Sydney, Australia; and Houston, Texas From Blacktown Hospital; the Department of Head and Neck Surgery, The Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital; the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center; and the Department of Head and Neck Surgery, Liverpool Hospital.
Plast Reconstr Surg. 2013 Sep;132(3):645-655. doi: 10.1097/PRS.0b013e31829acf5c.
A number of microvascular free-flap tissue transfer techniques exist for reconstruction of head and neck defects. The scapular free flap is a versatile option that can be used for a wide variety of defects in this complex region.
A series of 42 free flaps from 41 patients was retrospectively identified from the senior author's (J.R.C.) [corrected] database between 2006 and 2012. Information regarding patient demographics, indication for surgery, type of flap, reconstructive methods, complications, and prosthodontic outcome were reviewed and have been described.
A wide range of defects were reconstructed using the scapular free flap. Of the 42 reconstructions, 24 were for mandibular, 13 were for maxillary, and five were for calvarial reconstruction. The patients' ages ranged from 28 to 82 years, with a median of 70 years. Dental restoration was achieved in eight patients with maxillary reconstruction and two patients with mandibular reconstruction. There were 11 major complications, including two total flap failures.
The authors have found the scapular free flap to be a reliable, robust, and versatile flap that provides an unparalleled range of reconstructive options, with minimal donor-site morbidity. Thus, the authors believe that the scapular free flap is a valuable reconstructive option for patients with complex head and neck defects and in patients in whom comorbid disease contraindicates the use of the fibular free flap.
有许多微血管游离皮瓣组织转移技术可用于头颈部缺陷的重建。肩胛骨游离皮瓣是一种用途广泛的选择，可以用于该复杂区域的各种不同的缺陷。
从 2006 年至 2012 年，高级作者（J.R.C.）[更正]的数据库中回顾性地确定了 41 名患者的 42 例游离皮瓣。对患者人口统计学资料、手术指征、皮瓣类型、重建方法、并发症和修复体结果进行了回顾，并进行了描述。
使用肩胛骨游离皮瓣重建了广泛的缺陷。在 42 例重建中，24 例为下颌骨，13 例为上颌骨，5 例为颅骨重建。患者年龄 28 至 82 岁，中位数为 70 岁。上颌骨重建的 8 例患者和下颌骨重建的 2 例患者实现了牙修复。有 11 例主要并发症，包括 2 例全皮瓣失败。
作者发现肩胛骨游离皮瓣是一种可靠、强大且用途广泛的皮瓣，它提供了无与伦比的重建选择，供区并发症极小。因此，作者认为，肩胛骨游离皮瓣是一种有价值的重建选择，适用于头颈部复杂缺陷的患者，以及因合并疾病而不适合使用腓骨游离皮瓣的患者。
