口腔颌面部缺损的硬件并发症：肩胛骨和腓骨游离皮瓣重建的比较。
Hardware complications in oromandibular defects: Comparing scapular and fibular based free flap reconstructions.
机构信息
Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Hospital Network, Toronto, Ontario, Canada; Department of Otolaryngology-Head & Neck Surgery, Toronto, Ontario, Canada.
Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Hospital Network, Toronto, Ontario, Canada.
出版信息
Oral Oncol. 2017 Aug;71:163-168. doi: 10.1016/j.oraloncology.2017.06.020. Epub 2017 Jun 27.
BACKGROUND
Despite improvements in surgical technique and technology, hardware complications occur relatively frequently. This study analyzes hardware complications in patients undergoing oromandibular reconstruction using scapular (SFF) or fibular (FFF) free flaps.
METHODS
Retrospective data for 178 patients was obtained (1999-2014) at University Hospital Network (Toronto, Canada). Univariable and multivariable analyses were performed to identify risk factors for hardware complications.
RESULTS
Patients with FFF reconstruction (n=129) had significantly more hardware complications than those with SFF (n=49) (16% vs. 2%;p=0.01). Surgical site infection (SSI) (OR=7.05; p<0.01), defect type (OR=2.63; p<0.01) and flap (OR=0.12; p=0.01) were significant predictors of hardware complications on univariable analysis. Flap type (OR=0.12; p=0.04) was an independent predictor of plate complication after adjusting for SSI. A subgroup analysis suggested a trend towards fewer hardware complications with SFF stratified by mandibular defect type.
CONCLUSIONS
Scapular free flaps are associated with a lower rate of hardware-related complications in oromandibular reconstruction.
背景
尽管手术技术和技术有所改进，但硬件并发症仍相对频繁发生。本研究分析了使用肩胛骨（SFF）或腓骨（FFF）游离皮瓣进行口颌重建的患者的硬件并发症。
方法
在加拿大大学医院网络（多伦多）获得了 178 名患者的回顾性数据（1999-2014 年）。进行单变量和多变量分析，以确定硬件并发症的危险因素。
结果
与 SFF（n=49）重建的患者相比，接受 FFF 重建的患者（n=129）硬件并发症明显更多（16%比 2%；p=0.01）。手术部位感染（SSI）（OR=7.05；p<0.01）、缺损类型（OR=2.63；p<0.01）和皮瓣（OR=0.12；p=0.01）是硬件并发症的单变量分析的显著预测因素。在调整 SSI 后，皮瓣类型（OR=0.12；p=0.04）是板并发症的独立预测因素。亚组分析表明，SFF 分层的下颌骨缺损类型与硬件相关并发症的发生率较低有关。
结论
肩胛骨游离皮瓣与口颌重建中硬件相关并发症的发生率较低有关。
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