Harris Brianna N, Bewley Arnaud F
Davis Department of Otolaryngology - Head and Neck Surgery, University of California, Sacramento, California, United States.
Curr Opin Otolaryngol Head Neck Surg. 2016 Oct;24(5):447-52. doi: 10.1097/MOO.0000000000000286.
Fasciocutaneous and osteocutaneous free flap reconstruction has significantly changed the way surgeons reconstruct defects following ablation of head and neck tumors. Over time, success rates of free flaps have approached 98%, allowing surgeons to shift their focus to minimizing morbidities associated with the donor sites. The radial forearm, anterolateral thigh, and fibula free flaps are the three most commonly used flaps in head and neck reconstruction, and therefore each of their advantages and associated morbidities are of particular interest. The present article aims to review the morbidities associated with each of the commonly used head and neck free flaps and techniques to minimize them that are described in the most recent literature.
New techniques such as negative-pressure wound therapy, full thickness grafts, and rotational flaps have been developed recently that minimize these morbidities.
The techniques described in the current review may improve long-term patient outcomes both esthetically and functionally.
筋膜皮瓣和骨皮瓣游离组织移植重建显著改变了外科医生对头颈部肿瘤切除术后缺损进行重建的方式。随着时间的推移，游离组织移植的成功率已接近98%，这使得外科医生能够将重点转移到尽量减少供区相关的并发症上。桡侧前臂皮瓣、股前外侧皮瓣和腓骨游离皮瓣是头颈部重建中最常用的三种皮瓣，因此它们各自的优点和相关并发症尤其受到关注。本文旨在综述与每种常用头颈部游离皮瓣相关的并发症以及最新文献中描述的将这些并发症降至最低的技术。
最近已开发出负压伤口治疗、全厚皮片移植和旋转皮瓣等新技术，可将这些并发症降至最低。
本综述中描述的技术可能在美学和功能上改善患者的长期预后。
