Department of Plastic and Reconstructive Surgery, Research Institute of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
Head Neck. 2018 Nov;40(11):2399-2408. doi: 10.1002/hed.25347. Epub 2018 Sep 3.
Monitoring free muscle flaps with skin grafts is difficult. To intensify the monitoring process for this type of flap, a small skin paddle was included in the flap and analyzed its effects.
A retrospective analysis of all patients who underwent scalp reconstruction with a free latissimus dorsi flap and skin graft between 1994 and 2016 was conducted. Flap monitoring was proceeded using a combination of clinical examination and handheld Doppler for both types of flaps.
A total of 71 patients were included in this study and were divided into a study group (skin paddle included; n = 30) and a control group (conventional method; n = 41). The time between initial surgery to pedicle exploration was significantly shorter in the study group (11.3 ± 2.5 vs 79.8 ± 42.6 hours; P = .024). The flap salvage rate was significantly higher in the study group (100% vs 16.7%; P = .048).
The efficacy of flap monitoring and flap salvage outcomes were improved by including a small monitoring skin flap.
带皮移植的游离肌肉皮瓣监测较为困难。为加强此类皮瓣的监测过程，在皮瓣中加入一个小的皮瓣并分析其效果。
对 1994 年至 2016 年间所有接受游离背阔肌皮瓣和皮片移植进行头皮重建的患者进行回顾性分析。两种皮瓣均采用临床检查和手持式多普勒结合的方法进行监测。
本研究共纳入 71 例患者，分为研究组（含皮瓣；n = 30）和对照组（常规方法；n = 41）。研究组初次手术至蒂部探查的时间明显缩短（11.3 ± 2.5 比 79.8 ± 42.6 小时；P =.024）。研究组皮瓣成活率明显提高（100%比 16.7%；P =.048）。
通过包含一个小的监测皮瓣，提高了皮瓣监测和皮瓣成活率的效果。
