Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
J Craniomaxillofac Surg. 2018 Aug;46(8):1263-1267. doi: 10.1016/j.jcms.2018.04.021. Epub 2018 May 4.
When combined with iliac bone, perforator flaps are more chimeric, and there is increased mobile skin island to reconstruct soft tissue defects in the oral and maxillofacial region. This study examined oromandibular defects reconstructed using deep circumflex iliac artery perforator flap with iliac crest (DCIAPF). We retrospectively reviewed records of 23 patients with mandibular defects received DCIAPFs after oncological resection for oromandibular reconstruction from November 2015 to August 2016. All perforators, identified before surgery by Doppler examination, were terminal perforators of DCIA. DCIAPFs were successfully harvested in all patients. The flap survival rate was 95.6% (22/23); one flap failed due to artery spasm. Three patients developed slight skinedge necrosis in the skin island. Anatomical reconstruction contour of the mandible and sufficient bone length and height were achieved, with no serious donor-site complications during the follow-up period. The results demonstrated that DCIAPF is a favorable single-flap option for oromandibular reconstruction after oncological resection with fewer donor-site complications because of its adequate bone tissue and satisfactory soft tissue, with a constant location of the perforator.
当与髂骨结合使用时,穿支皮瓣的嵌合度更高,并且有更多可移动的皮岛来重建口腔颌面部的软组织缺损。本研究检查了使用旋髂深动脉穿支皮瓣和髂嵴(DCIAPF)重建的口腔颌面部缺损。我们回顾性分析了 2015 年 11 月至 2016 年 8 月期间因口腔颌面部肿瘤切除后接受 DCIAPF 修复的 23 例下颌骨缺损患者的病历。所有穿支均在术前通过多普勒检查确定,均为 DCIA 的终末穿支。所有患者均成功采集了 DCIAPF。皮瓣成活率为 95.6%(22/23);1 例因动脉痉挛导致皮瓣失败。3 例患者出现轻微的皮岛边缘坏死。在随访期间,下颌骨的解剖重建轮廓、足够的骨长度和高度得以实现,供区无严重并发症。结果表明,DCIAPF 是一种有利的单瓣选择,用于口腔颌面部肿瘤切除后的重建,因为其具有充足的骨组织和满意的软组织,且穿支的位置恒定,因此供区并发症较少。