Miyamoto Shimpei, Kayano Shuji, Umezawa Hiroki, Fujiki Masahide, Sakuraba Minoru
From the *Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo; and †Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
J Craniofac Surg. 2013;24(5):1739-40. doi: 10.1097/SCS.0b013e31829a8621.
Postoperative monitoring of buried anterolateral thigh flaps is difficult with standard methods. Although a monitoring skin flap based on a second cutaneous perforator is often used, it requires tedious dissection of 2 sets of perforators and cannot be used when a second perforator is absent. We present 2 patients who underwent head and neck reconstruction with buried anterolateral thigh flaps, which were monitored with a small, externalized segment of the vastus lateralis muscle accompanying the main skin island. Both flaps survived, and the monitoring muscle flaps remained pink throughout the postoperative period until removal. For monitoring, a vastus lateralis muscle flap has several advantages over a skin flap. This method obviates the need for dissecting a second cutaneous perforator and allows reliable monitoring regardless of the number of available cutaneous perforators. We believe this method is a versatile option for monitoring buried anterolateral thigh flaps.
采用标准方法对埋藏式股前外侧皮瓣进行术后监测很困难。尽管常使用基于第二皮肤穿支的监测皮瓣，但这需要繁琐地解剖两组穿支，且在没有第二穿支时无法使用。我们报告了2例接受埋藏式股前外侧皮瓣进行头颈部重建的患者，通过伴随主要皮岛的一小段外置股外侧肌对皮瓣进行监测。两个皮瓣均存活，监测肌瓣在术后直至移除期间一直保持粉红色。对于监测而言，股外侧肌瓣比皮瓣具有多个优势。该方法无需解剖第二皮肤穿支，且无论可用皮肤穿支数量如何均可进行可靠监测。我们认为该方法是监测埋藏式股前外侧皮瓣的一种通用选择。
