Riecke B, Assaf A T, Heiland M, Al-Dam A, Gröbe A, Blessmann M, Wikner J
Department of Oral and Maxillofacial Surgery, University Medical Centre Hamburg Eppendorf, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Centre Hamburg Eppendorf, Germany.
Int J Oral Maxillofac Surg. 2015 Aug;44(8):937-41. doi: 10.1016/j.ijom.2015.02.021. Epub 2015 Mar 21.
A novel technique to reduce donor site morbidity after radial forearm free flap (RFFF) harvest, using a local full-thickness skin graft (FTSG), is described. Thirty consecutive patients undergoing RFFF for head and neck reconstruction were enrolled in a prospective study. Donor site defect closure was performed with spindle-shaped FTSGs excised from the wavelike skin incision made for the vascular pedicle. Both the removal site of the FTSG on the volar forearm and the covered RFFF donor site healed uneventfully in 29 cases, with no impairment of function related to the skin graft. No skin graft failure and no exposure, tenting, or adherence of the flexor tendons occurred. All patients expressed satisfaction with postoperative pain, the functional outcome, and cosmetic appearance. Primary donor site defect closure could be achieved in all cases with the use of a local FTSG. This graft can be gained at the access incision for the vascular pedicle, avoids expansion of the incision for a local flap technique, and does not prolong wound healing, and thus reduces both donor site and graft site morbidity of the RFFF. This technique leads to an inconspicuous aesthetic result with no apparent relevant functional deficits and avoids the need for a second donor site.
本文描述了一种在切取桡侧前臂游离皮瓣（RFFF）后减少供区并发症的新技术，即使用局部全厚皮片移植（FTSG）。连续30例接受RFFF进行头颈部重建的患者纳入一项前瞻性研究。供区缺损采用从为血管蒂制作的波浪形皮肤切口切取的梭形FTSG进行闭合。29例患者中，FTSG取自掌侧前臂的部位及覆盖的RFFF供区均顺利愈合，未出现与皮肤移植相关的功能损害。未发生皮肤移植失败，屈肌腱未出现外露、帐篷样改变或粘连。所有患者对术后疼痛、功能结局及外观均表示满意。使用局部FTSG可在所有病例中实现供区原发性缺损的闭合。这种皮片可在血管蒂的切口处获取，避免了局部皮瓣技术切口的扩大，且不延长伤口愈合时间，从而降低了RFFF供区及植皮区的并发症。该技术可获得不显眼的美学效果，无明显相关功能缺陷，且避免了需要第二个供区。
