Hsieh Tsung-Yen, Bewley Arnaud
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
Curr Opin Otolaryngol Head Neck Surg. 2019 Oct;27(5):392-400. doi: 10.1097/MOO.0000000000000574.
To review the recent literature on the use of multiple flaps in head and neck reconstruction with attention to form, function, outcomes, and complications.
Multiple free flap reconstructions are technically feasible with high flap survival rates, tolerable complication rates, and overall adequate functional and aesthetic outcomes, given the large extent of the defects and the high surgical complexity of these cases.
Multiple free flap reconstructions should be considered in cases of large defects involving multiple functional regions and tissue types, which most often arises following resection of advanced malignancies. As there is mortality benefit with clear surgical margins and eradication of malignant lymph nodes, larger resections should be pursued if necessary, followed by a multiple flap reconstruction.
回顾近期关于在头颈部重建中使用多个皮瓣的文献，重点关注形态、功能、结果和并发症。
鉴于缺损范围大且手术复杂程度高，多个游离皮瓣重建在技术上是可行的，皮瓣存活率高，并发症发生率可耐受，总体功能和美学效果良好。
对于涉及多个功能区域和组织类型的大面积缺损病例，应考虑进行多个游离皮瓣重建，这种情况最常见于晚期恶性肿瘤切除术后。由于手术切缘清晰和清除恶性淋巴结对降低死亡率有益，如有必要应进行更大范围的切除，随后进行多个皮瓣重建。
