Mochizuki Yumi, Tomioka Hirofumi, Tushima Fumihiko, Shimamoto Hiroaki, Hirai Hideaki, Oikawa Yuu, Harada Hiroyuki
Department of Oral and Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo 113-8549, Japan.
Ann Maxillofac Surg. 2016 Jul-Dec;6(2):228-234. doi: 10.4103/2231-0746.200346.
This study aimed to evaluate the coverage of oral wounds using either a polyglycolic acid (PGA) sheet or split-thickness skin grafting (STSG).
A total of 119 cases of wound coverage using a PGA sheet and fibrin glue spray as well as 132 cases of wound coverage cases using STSG were reviewed retrospectively. The site of the excision area, perioperative conditions, and postoperative functional problems were evaluated.
The PGA group had significantly shorter operation time, earlier start of oral intake, and shorter hospitalization than the STSG group. If the PGA sheet over the wound with exposed bone could be protected by a surgical sprint, oral food intake could be started on the day after surgery at the earliest. When the size of the wound in the buccal excisional area was classified into two groups (<6 or ≥6 cm), mouth opening in the STSG group was significantly larger at 3 months postoperatively. When the size of the wound in the tongue and floor of mouth was classified into two groups (<12 or ≥12 cm), the STSG group had a significantly higher score in postoperative speech intelligibility.
Selection of a PGA sheet or STSG based on the consideration of defect size, tumor location, patients' local and general condition and tolerance for surgery could reduce the patients' postsurgical dysfunctional problems.
本研究旨在评估使用聚乙醇酸（PGA）片或中厚皮片移植（STSG）覆盖口腔伤口的效果。
回顾性分析119例使用PGA片和纤维蛋白胶喷雾覆盖伤口的病例以及132例使用STSG覆盖伤口的病例。评估切除区域的部位、围手术期情况和术后功能问题。
PGA组的手术时间明显短于STSG组，开始经口进食时间更早，住院时间更短。如果伤口上覆盖有暴露骨的PGA片能通过手术贴膜得到保护，最早可在术后第一天开始经口进食。当颊部切除区域伤口大小分为两组（<6或≥6 cm）时，STSG组术后3个月的开口度明显更大。当舌部和口底伤口大小分为两组（<12或≥12 cm）时，STSG组术后语音清晰度得分明显更高。
根据缺损大小、肿瘤位置、患者局部和全身状况以及对手术的耐受性来选择PGA片或STSG，可以减少患者术后的功能障碍问题。
