Karabulut Burak
Otolaryngology Department, Kartal Dr. Lütfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
J Craniofac Surg. 2020 Jun;31(4):e372-e375. doi: 10.1097/SCS.0000000000006315.
Free flaps have been considered as the gold standard for reconstruction of head and neck region after ablative oncologic surgery. However, the reconstructive surgeon's armamentarium should also involve pedicled flaps for certain situations such as patients having comorbid diseases necessiating shorter duration of surgical procedure. The supraclavicular flap is a pedicled thin fasciacutaneous flap used to reconstruct the defects in head and neck area. The flap has advantages of wide rotation of arc, easy matching with skin color of recipient area and relatively shorter flap harvesting time. Its bloods supply depends on supraclavicular artery which is a branch of transverse cervical artery. Between August 2016 and September 2019, the pedicled supraclavicular flap was used to reconstruct 17 head and neck cancers patients after ablative oncologic surgery. In 15 patients this flap was primary choice and in 2 patients it was used as a salvage reconstructive tool. Two of 17 flaps had very distal partial necrosis. There was no total loss of any flap. Flap harvesting time was always less than 1 hour. Mean duration for drainage tube removal at the donor side was 5 days. Functional outcomes were perfect. In our suggestion pedicled supraclavicular flap is a very good alternative option to free flap reconstruction especially for skin and oral cavity defects.
游离皮瓣一直被视为头颈部肿瘤切除术后重建的金标准。然而，对于某些情况，如患有需要缩短手术时间的合并症的患者，重建外科医生的手术器械库也应包括带蒂皮瓣。锁骨上皮瓣是一种带蒂的薄筋膜皮瓣，用于重建头颈部区域的缺损。该皮瓣具有旋转弧度大、易于与受区皮肤颜色匹配以及皮瓣切取时间相对较短等优点。其血供依赖于锁骨上动脉，锁骨上动脉是颈横动脉的分支。2016年8月至2019年9月，采用带蒂锁骨上皮瓣对17例头颈部肿瘤切除术后患者进行重建。15例患者将该皮瓣作为首选，2例患者将其用作挽救性重建工具。17例皮瓣中有2例出现非常远端的部分坏死。没有任何皮瓣完全坏死。皮瓣切取时间始终少于1小时。供区引流管拔除的平均时间为5天。功能结果良好。我们认为，带蒂锁骨上皮瓣是游离皮瓣重建的一个非常好的替代选择，特别是对于皮肤和口腔缺损。
