Chen Collin L, Zenga Joseph, Roland Lauren T, Pipkorn Patrik
Department of Otolaryngology - Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.
Head Neck. 2018 Mar;40(3):632-646. doi: 10.1002/hed.25005. Epub 2017 Nov 15.
The purpose of this clinical review was to assess the feasibility of reconstructing complex head and neck defects with 2 or more free flaps simultaneously.
A total of 38 articles were reviewed. The patient population included those who received 2 or more free flaps or a single free flap plus a locoregional flap. The primary outcome assessed was rate of complications.
Among double flaps, the minor complication rate was 6.96% and the major complication rate was 20.0%. In comparison, the free flap plus locoregional flap group had higher rates of minor and major complications of 30.4% and 29.5%, respectively. The median operating time was 660 minutes for double flaps and 602 minutes for free flap plus locoregional flap (P = .828).
Compared to the single free flap plus locoregional flap, double free flaps are relatively reliable without increasing surgical complications or decreasing flap survival, while only modestly increasing operating times.
本临床综述的目的是评估同时使用两个或更多游离皮瓣修复复杂头颈部缺损的可行性。
共回顾了38篇文章。患者群体包括接受两个或更多游离皮瓣或一个游离皮瓣加局部皮瓣的患者。评估的主要结局是并发症发生率。
在双皮瓣组中， minor并发症发生率为6.96%，major并发症发生率为20.0%。相比之下，游离皮瓣加局部皮瓣组的minor和major并发症发生率分别较高，为30.4%和29.5%。双皮瓣组的中位手术时间为660分钟，游离皮瓣加局部皮瓣组为602分钟（P = 0.828）。
与单个游离皮瓣加局部皮瓣相比，双游离皮瓣相对可靠，不会增加手术并发症或降低皮瓣存活率，同时仅适度增加手术时间。
