Urken M L, Weinberg H, Vickery C, Buchbinder D, Biller H F
Department of Otolaryngology, Mount Sinai Medical Center, New York, NY 10029.
Arch Otolaryngol Head Neck Surg. 1989 Dec;115(12):1447-53. doi: 10.1001/archotol.1989.01860360049016.
Postoperative monitoring of the perfusion of a free flap used in head and neck reconstruction is vitally important in achieving a favorable outcome. There are a wide range of methods that have been advocated to assist in this surveillance. However, at this time, there is no one technique that is universally efficacious in detecting early arterial and venous occlusion. In our experience, the most reliable means of monitoring has been the clinical assessment of flap color, capillary refill, tissue turgor, and bleeding. To assess these parameters, a portion of the flap must be accessible for observation. When the defect is buried, as is often the case in head and neck reconstruction, flap design is critical to achieve a reliable external segment for monitoring. The methods for exteriorizing a well-vascularized portion of tissue in the most commonly used flaps are described.
对头颈部重建中使用的游离皮瓣灌注情况进行术后监测对于取得良好效果至关重要。人们提出了各种各样的方法来辅助这种监测。然而，目前尚无一种技术能在检测早期动静脉阻塞方面普遍有效。根据我们的经验，最可靠的监测手段是对皮瓣颜色、毛细血管再充盈、组织弹性和出血情况进行临床评估。为评估这些参数，必须有一部分皮瓣便于观察。当缺损被掩埋时，这在头颈部重建中很常见，皮瓣设计对于获得可靠的用于监测的外部部分至关重要。本文描述了在最常用的皮瓣中将血运良好的组织部分外置的方法。
