Zuo Liang, Yu Jianjun, Zhou Xiao, Dai Jie, Tian Hao, Shan Zhenfeng, Hu Jie, Chen Xing, Wang Honghan, Cai Xu, Gao Shuichao
The Second Department of Head and Neck Surgery, Department of Oncoplastic Surgery, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha Hunan, 410013, P.R.China.
The Second Department of Head and Neck Surgery, Department of Oncoplastic Surgery, Hunan Cancer Hospital & the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha Hunan, 410013,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Mar 15;32(3):346-349. doi: 10.7507/1002-1892.201711046.
To investigate the effectiveness of free anterolateral thigh Kiss flap in repair of large scalp defect after malignant tumor resection.
Between December 2012 and December 2016,18 patients with large scalp defect after malignant tumor resection were treated. There were 16 males and 2 females with an average age of 52.6 years (range, 43-62 years). There were 17 cases of squamous carcinoma and 1 case of dermatofibrilsarcoma protuberan. The size of scalp defect ranged from 15 cm×10 cm to 17 cm×12 cm after resection of tumors. The scalp defects were repaired with the free anterolateral thigh Kiss flap. And the size of flap ranged from 15 cm×6 cm to 20 cm×8 cm. The skull was completely resected in 2 cases, and repaired with Titanium mesh. The sizes of skull defects were 12 cm×10 cm and 10 cm×8 cm. The donor site was sutured directly.
Eighteen flaps survived with primary healing of wounds; and healing by first intention was obtained at the donor sites. One patient died because of intracranial metastasis at 5 months after operation, and no local recurrence occurred in the other 17 patients. The follow-up time ranged from 6 months to 4 years (mean, 26.6 months). The results of both appearance and function were satisfactory, without ulceration during follow-up. No obvious scar was found at donor sites and no obvious impairment was observed after harvesting free anterolateral thigh flap.
Large scalp defects after malignant tumor resection can be effectively repaired by free anterolateral thigh Kiss flap. The donor site can be sutured directly, without skin grafting, thus avoiding the secondary donor site.
探讨游离股前外侧双叶皮瓣修复恶性肿瘤切除术后大面积头皮缺损的疗效。
2012年12月至2016年12月,对18例恶性肿瘤切除术后大面积头皮缺损患者进行治疗。男16例,女2例,平均年龄52.6岁(43 - 62岁)。鳞状细胞癌17例,隆突性皮肤纤维肉瘤1例。肿瘤切除后头皮缺损大小为15 cm×10 cm至17 cm×12 cm。采用游离股前外侧双叶皮瓣修复头皮缺损,皮瓣大小为15 cm×6 cm至20 cm×8 cm。2例患者颅骨全层切除,采用钛网修复,颅骨缺损大小分别为12 cm×10 cm和10 cm×8 cm。供区直接缝合。
18例皮瓣全部成活,创面一期愈合,供区均一期愈合。1例患者术后5个月因颅内转移死亡,其余17例患者均无局部复发。随访时间6个月至4年(平均26.6个月),外观和功能恢复满意,随访期间无溃疡形成。供区未见明显瘢痕,切取游离股前外侧皮瓣后未出现明显功能障碍。
游离股前外侧双叶皮瓣可有效修复恶性肿瘤切除术后大面积头皮缺损,供区可直接缝合,无需植皮,避免了供区二次损伤。