Pink Richard, Dvořák Zdeněk, Heinz Petr, Michl Petr, Tvrdý Petr, Azar Basel
Klin Onkol. 2017 Winter;31(1):59-65. doi: 10.14735/amko201859.
There has been a consistent increase in the number of publications on pedicled flaps for the reconstruction of post ablation defects in the oropharyngeal area. In principle, tissue is lifted from a donor site and moved to a recipient site without disruption of blood supply. The donor site is an exact anatomically defined region of tissue that is capable of sustaining its own blood supply. The benefits of pedicled flaps include lower technical demands that obviate the need for microsurgical anastomosis and shorter operating times. For this reason, they are mostly indicated in elderly and at risk patients. The aim of this paper is to describe our experience with the regional (pedicled) (submental, supraclavicular) flaps with a focus on reliability, function, cosmesis, donor site morbidity, and oncological safety.
Reconstructive techniques using distal flaps are described in 12 patients. A submental flap for reconstruction was used in 7 patients. In 5 patients, we used the supraclavicular flap. A total of 9 patients were treated primarily for squamous cell carcinoma of the orofacial region, and 3 for low-grade adenocarcinoma of the small salivary gland.
In 5 patients, there was successful engraftment of the submental flap. Ischemia and necrosis of the edges of the flap occurred in 1 case. In one patient, the 3rd day after surgery, the flap was almost totally necrotised. The supraclavicular flap in 4 patiets healed completely, 1 time during the postoperative period it was infected with partial loss of the outer part of the flap from the pre auricular region. In one case there was necrosis of the terminal part of the flap in the reconstructed part of the tongue, the defect was healed by granulation tissue. In all patients, after reconstruction using supraclavicular and submental flaps, the donor site closed primarily with minimal morbidity.
Regional (pedicled) flaps are thin, and pliable with good cosmetic and functional results. Reconstruction using these flaps can be accomplished in one-stage with minimum morbidity of the donor site.Key words: pedicled flap - surgical flap - head and neck cancersSubmitted: 11. 5. 2017Accepted: 5. 11. 2017 The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
关于带蒂皮瓣用于口咽区域消融后缺损重建的文献数量持续增加。原则上，组织从供区提起并转移至受区，而不破坏血供。供区是解剖学上明确界定的、能够维持自身血供的组织区域。带蒂皮瓣的优点包括技术要求较低，无需显微外科吻合，手术时间较短。因此，它们主要适用于老年患者和高危患者。本文旨在描述我们使用区域（带蒂）（颏下、锁骨上）皮瓣的经验，重点关注可靠性、功能、美容效果、供区并发症及肿瘤学安全性。
描述了12例患者使用远端皮瓣的重建技术。7例患者使用颏下皮瓣进行重建。5例患者使用锁骨上皮瓣。总共9例患者主要治疗口面部鳞状细胞癌，3例治疗小涎腺低级别腺癌。
7例颏下皮瓣患者中，5例皮瓣成功移植。1例出现皮瓣边缘缺血坏死。1例患者在术后第3天，皮瓣几乎完全坏死。5例锁骨上皮瓣患者中，4例完全愈合，1例在术后期间发生感染，耳前区域皮瓣外部部分部分缺失。1例患者舌重建部位皮瓣末端坏死，缺损通过肉芽组织愈合。所有患者使用锁骨上皮瓣和颏下皮瓣重建后，供区一期闭合，并发症轻微。
区域（带蒂）皮瓣薄且柔韧，美容和功能效果良好。使用这些皮瓣进行重建可一期完成，供区并发症最少。关键词：带蒂皮瓣 - 手术皮瓣 - 头颈癌提交日期：2017年5月11日接受日期：2017年11月5日作者声明他们在研究中使用的药物、产品或服务不存在潜在利益冲突。编辑委员会声明该手稿符合ICMJE关于生物医学论文的建议。
