Kalfarentzos Evagelos, Ma Chunyue, Tian Zhuowei, Zhu Hanguang, He Yue
Clinical Fellow, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Oral Maxillofac Surg. 2015 Feb;73(2):341-8. doi: 10.1016/j.joms.2014.08.001. Epub 2014 Aug 10.
The purposes of this study were to evaluate the clinical application and efficacy of the dorsalis pedis fasciocutaneous flap in the reconstruction of oral cavity defects and to assess the associated donor-site morbidity.
From September 2009 to December 2012, 7 patients with associated oral cavity defects resulting from tumor resection underwent reconstruction with a dorsalis pedis fasciocutaneous flap. Surgical anatomy and harvesting procedure of the dorsalis pedis flap are described. Special consideration was given to the associated donor-site morbidity.
All flaps survived without any complications. All 7 flaps were based on the dorsalis pedis artery and the greater saphenous vein for perfusion and drainage respectively. In all 7 cases, the donor site was closed with a full-thickness skin graft, with no associated healing complications or functional deficit of the foot. The resulting scar was well hidden in the lower extremity.
The dorsalis pedis fasciocutaneous flap is a thin and pliable flap sharing many similarities with the radial forearm flap, thus making it ideal for intraoral reconstruction. Proper intraoperative and postoperative care of the donor site can result in minimal morbidity, as shown in this study. This flap may provide an ideal alternative to the radial forearm free flap, with the added advantages of a well-hidden scar and a high level of patient satisfaction.
本研究旨在评估足背筋膜皮瓣在口腔缺损修复中的临床应用及疗效,并评估相关供区并发症。
2009年9月至2012年12月,7例因肿瘤切除导致口腔缺损的患者接受了足背筋膜皮瓣修复。描述了足背皮瓣的手术解剖及切取方法。特别关注了相关供区并发症。
所有皮瓣均存活,无任何并发症。所有7个皮瓣分别以足背动脉和大隐静脉为供血和回流血管。7例患者的供区均采用全厚皮片移植关闭,足部无相关愈合并发症或功能障碍。形成的瘢痕在下肢易于隐藏。
足背筋膜皮瓣是一种薄而柔韧的皮瓣,与桡侧前臂皮瓣有许多相似之处,因此是口腔内修复的理想选择。如本研究所示,对供区进行适当的术中及术后护理可使并发症降至最低。该皮瓣可能为桡侧前臂游离皮瓣提供理想的替代方案,具有瘢痕易于隐藏和患者满意度高的额外优势。