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薄型股前外侧皮瓣在头颈部缺损修复中的应用。

Application of Thinned Anterolateral Thigh Flap for the Reconstruction of Head and Neck Defects.

作者信息

Gong Zhao-Jian, Wang Kai, Tan Hong-Yu, Zhang Sheng, He Zhi-Jing, Wu Han-Jiang

机构信息

Resident, Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.

Visiting Physician, Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.

出版信息

J Oral Maxillofac Surg. 2015 Jul;73(7):1410-9. doi: 10.1016/j.joms.2015.01.006. Epub 2015 Jan 20.

Abstract

PURPOSE

To evaluate the feasibility and reconstructive efficacy of the thinned anterolateral thigh (ALT) flap for the reconstruction of head and neck defects.

PATIENTS AND METHODS

A retrospective review was performed of 43 patients who had undergone reconstruction of head and neck defects with a thinned ALT flap from January 2009 through December 2013 at the Second Xiangya Hospital. The methods for flap thinning and defect reconstruction and reconstructive efficacy are reported.

RESULTS

The flaps were 5 cm × 7 cm to 9 cm × 14 cm, and all were harvested from a single cutaneous perforator. Postoperatively, 40 flaps survived completely and 3 flaps experienced partial necrosis. Venous compromise occurred in 2 cases, both of which were salvaged after operative exploration. Of the 43 donor sites, 41 were closed directly and resulted in only linear scars, and 2 were closed using full-thickness skin grafts because the defect was larger. All the patients were followed for approximately 6 to 36 months, and they were satisfied with the esthetic and functional results of the donor and recipient sites after reconstruction.

CONCLUSION

With the high success rate of flap transplantation, satisfactory functional and esthetic results, and lower complication rates at the donor and recipient sites, the use of thinned ALT flaps can be a good choice for the reconstruction of head and neck defects in obese patients.

摘要

目的

评估薄型股前外侧(ALT)皮瓣修复头颈部缺损的可行性及修复效果。

患者与方法

回顾性分析2009年1月至2013年12月在中南大学湘雅二医院采用薄型ALT皮瓣修复头颈部缺损的43例患者。报告皮瓣修薄方法、缺损修复方法及修复效果。

结果

皮瓣大小为5 cm×7 cm至9 cm×14 cm,均由单一皮穿支供血。术后,40例皮瓣完全成活,3例皮瓣部分坏死。2例发生静脉危象,均经手术探查挽救。43个供区中,41个直接缝合,仅遗留线性瘢痕,2个因缺损较大采用全厚皮片移植修复。所有患者随访6至36个月,对修复后供区和受区的美观及功能效果均满意。

结论

薄型ALT皮瓣移植成功率高,供区和受区功能及美观效果满意,并发症发生率低,可作为肥胖患者头颈部缺损修复的良好选择。

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