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口腔癌手术中浅层外科缺损的皮肤移植替代方法。

An alternative to skin graft for superficial surgical defect in oral cancer surgery.

机构信息

Azienda Sanitaria Universitaria Integrata di Trieste, Head and Neck Department, ENT Clinic, Trieste, Italy.

Azienda Sanitaria Universitaria Integrata di Trieste, Head and Neck Department, ENT Clinic, Trieste, Italy.

出版信息

Braz J Otorhinolaryngol. 2021 Nov-Dec;87(6):678-682. doi: 10.1016/j.bjorl.2020.02.002. Epub 2020 Mar 11.

Abstract

INTRODUCTION

After surgery for oral cavity cancer, superficial surgical defects are usually covered with a skin graft that can be harvested with different thicknesses depending on the reconstructive need. Despite its popularity and efficacy, this solution has the disadvantage of excessive harvesting times and scarring of the donor site. Other surgeons have proposed the use of bovine pericardium as a reconstructive solution. Its use in otorhinolaryngology especially after oral cavity surgery has never been reported.

OBJECTIVE

The aim of this manuscript is to present our preliminary experience with the use of a collagen membrane obtained from bovine pericardium in the reconstruction of small and superficial defects after transoral resection of oral cavity tumors.

METHODS

A bovine collagen membrane was used to cover surgical defects in 19 consecutive patients undergoing transoral resection of small/superficial oral cancers. Photographs were obtained in the postoperative period to follow the healing process. We analyzed the pro and cons of this tool, recorded data on postoperative chewing-, speech- and taste-related quality of life, and tested the most appropriate settings providing the best reconstructive result.

RESULTS

The bovine collagen membrane allowed us to cover surgical defects of varying size in different oral sites. Shaping and placement proved to be simple. The membrane facilitated physiologic tissue repair: after one month it was completely absorbed and replaced by the patient's own mucosa. No adverse features were observed in the cohort.

CONCLUSION

A bovine collagen membrane can represent a fast and easy solution in cases of split-thickness defect. Unlike a skin graft, it is not associated with donor site morbidity and allows the patient's own mucosa to be restored with a more physiological result.

摘要

简介

口腔癌手术后,通常使用皮片移植来覆盖浅表性手术缺损,皮片的厚度可根据重建需求进行选择。尽管这种方法应用广泛且有效,但它存在多次取皮和供区瘢痕的缺点。其他外科医生提出使用牛心包作为重建解决方案。然而,牛心包在耳鼻喉科中的应用,特别是在口腔手术后的应用,尚未见报道。

目的

本研究旨在介绍我们在经口切除口腔肿瘤后,使用牛心包胶原膜覆盖小面积和浅表性缺损的初步经验。

方法

我们使用牛胶原蛋白膜覆盖了 19 例经口切除小/浅表口腔癌患者的手术缺损。术后拍摄照片以跟踪愈合过程。我们分析了该工具的优缺点,记录了术后咀嚼、言语和味觉相关生活质量的数据,并测试了提供最佳重建效果的最合适设置。

结果

牛心包胶原膜可用于覆盖不同口腔部位大小不一的手术缺损。其塑形和放置都很简单。该膜促进了生理性组织修复:术后一个月,它完全被吸收并被患者自身的黏膜所取代。在该队列中未观察到任何不良反应。

结论

在部分厚度缺损的情况下,牛心包胶原膜可以作为一种快速且简单的解决方案。与皮片移植不同,它不会引起供区并发症,并且可以恢复患者自身的黏膜,获得更生理性的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3660/9422448/b2f5b1a00bb4/gr1.jpg

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