Liu Jie, Zhang Bin, Li De-zhi, Ni Song, An Chang-ming, Xu Zhen-gang, Liu Shao-yan
Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China (Email:
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jun;48(6):486-9.
To explore the proposal using nearby perforator flaps as alternative reconstructive choices for anterolateral thigh (ALT) flap when lacking useful perforator.
From August 2010 to August 2012, 8 cases with head and neck cancer were found lacking reliable perforator during ALT flap elevation, a tensor fascia latae (TFL) flap or an anteromedial thigh (AMT) flap was used to complete the reconstruction.
All 8 alternative flaps were successfully harvested, other donor sites were not needed. Flap harvest time was 50-85 min. Of 5 TFL flaps, pedicle lengths were 6-10 cm, and the diameters of the arteries and veins were 2.5-3.0 mm and 2.5-3.5 mm respectively. Of 3 AMT flaps, pedicle lengths were 10-15 cm, the rectus femoris branch was used as pedicle in 1 flap, with artery and vein more than 1.0 mm in diameter, and the descending branch of the lateral circumflex femoral artery was used as pedicle in other 2 flaps, the diameters of the arteries were 3.5 and 3.0 mm respectively, the diameters of the veins were 3.5 mm. The donor sites were directly closed in 7 cases and skin graft was performed in another case. All the flaps were alive and no complication was found in the donor sites.
TFL or AMT flap is an good alternative to ALT flap lacking useful perforator.
探讨在缺乏可用穿支血管时，采用邻近穿支皮瓣作为股前外侧（ALT）皮瓣替代重建选择的可行性。
2010年8月至2012年8月，8例头颈部癌患者在切取ALT皮瓣时发现缺乏可靠的穿支血管，采用阔筋膜张肌（TFL）皮瓣或股内侧（AMT）皮瓣完成重建。
8块替代皮瓣均顺利切取，无需另取供区。皮瓣切取时间为50 - 85分钟。5块TFL皮瓣中，蒂长6 - 10厘米，动脉直径2.5 - 3.0毫米，静脉直径2.5 - 3.5毫米。3块AMT皮瓣中，蒂长10 - 15厘米，1块皮瓣以股直肌支为蒂，动静脉直径均大于1.0毫米，另2块皮瓣以旋股外侧动脉降支为蒂，动脉直径分别为3.5毫米和3.0毫米，静脉直径为3.5毫米。7例供区直接缝合，1例进行了植皮。所有皮瓣均存活，供区未出现并发症。
TFL或AMT皮瓣是缺乏可用穿支血管的ALT皮瓣的良好替代选择。
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