Grinsell Damien, Herle Pradyumna
Department of Plastic Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.
Lymphatic and Regenerative Medicine, O'Brien Institute, St Vincent's Institute, Melbourne, Victoria, Australia.
ANZ J Surg. 2019 Jul;89(7-8):940-944. doi: 10.1111/ans.14980. Epub 2019 Feb 1.
Reconstruction of lip defects following neoplasia and trauma is a common procedure in plastic surgery. Reconstruction of large lip defects is a difficult undertaking and some degree of residual functional impairment and disability are likely to occur. Microsurgical reconstruction is the recommended technique for large lip defects; however, limitations exist regarding optimal aesthetic and functional outcomes with current free flap options.
We propose a new composite flap design based on the innervated pronator quadratus with the radial forearm free flap for a more dynamic reconstruction of total or near total lip defects. Results of our series of four patients have been reviewed.
The radial forearm flap - innervated pronator quadratus flap has been used in four patients thus far for lip reconstruction. This flap, in our limited series has shown excellent results in achieving oral competence, good motor function and acceptable cosmetic appearance.
The composite radial forearm-pronator quadratus flap is a promising new lip reconstruction technique that has potential to provide a higher level of oral competence, sphincteric function and symmetrical lip movement, than current microsurgical options in dynamic lip reconstruction. This method warrants further investigation in plastic surgery literature.
肿瘤切除及创伤后唇部缺损的修复是整形外科的常见手术。大型唇部缺损的修复是一项艰巨的任务，可能会出现一定程度的残余功能障碍和残疾。显微外科修复是大型唇部缺损的推荐技术；然而，目前的游离皮瓣选择在实现最佳美学和功能效果方面存在局限性。
我们提出一种基于带神经的旋前方肌与桡侧前臂游离皮瓣的新型复合皮瓣设计，用于更具动态性地修复全唇或近全唇缺损。我们回顾了4例患者的系列治疗结果。
迄今为止，桡侧前臂皮瓣-带神经的旋前方肌皮瓣已用于4例患者的唇部重建。在我们有限的病例系列中，该皮瓣在实现口腔闭合、良好的运动功能和可接受的外观方面显示出优异的效果。
桡侧前臂-旋前方肌复合皮瓣是一种有前景的新型唇部重建技术，在动态唇部重建中，与目前的显微外科方法相比，它有可能提供更高水平的口腔闭合、括约肌功能和对称的唇部运动。这种方法值得在整形外科学文献中作进一步研究。
