Wang Shun-Ji, Zhang Wen-Bo, Yu Yao, Wang Tai, Yang Hong-Yu, Peng Xin
Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Attending Doctor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Maxillofac Surg. 2020 Nov;78(11):2090-2098. doi: 10.1016/j.joms.2020.06.017. Epub 2020 Jun 15.
The anterolateral thigh flap (ALTF) volume will decrease over time after surgery. We measured and identified the risk factors for postoperative volume changes in the ALTF.
We designed and performed a retrospective cohort study of patients who had undergone reconstruction of oral and maxillofacial defects using ALTFs at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June 2012 to December 2018. We measured the volume of the ALTFs at 1, 3, 6, 12, and 24 months postoperatively; the flap volume at 1 month postoperatively was taken as the baseline. The primary outcome variables were the residual ALTF rates at 3, 6, 12, and 24 months postoperatively, defined as the ratio between the present volume at each month and at baseline. The primary predictor variables were the clinical variables that might be associated with ALTF volume loss. Descriptive and bivariate statistics were computed, and the P value for statistical significance was set at ≤ .05.
The sample included 70 subjects with a mean age of 53.8 years (46 men and 24 women). The postoperative residual rates at 3, 6, 12, and 24 months were 72.3, 69.0, 67.9, and 68.7%, respectively, of the baseline volume. The use of postoperative radiotherapy (P < .01) and low body mass index (BMI; P = .006) were significantly associated with postoperative ALTF volume loss.
The results of the present study suggest that ALTF volume shrinkage mainly occurs within 6 months postoperatively and that postoperative radiotherapy and a low BMI are risk factors for volume loss. Overcorrection should be performed to account for the shrinkage of ALTFs, and postoperative nutrition management is important to avoid ALTF volume loss.
股前外侧皮瓣（ALTF）术后体积会随时间减小。我们测量并确定了ALTF术后体积变化的危险因素。
我们设计并开展了一项回顾性队列研究，研究对象为2012年6月至2018年12月在北京大学口腔医学院口腔颌面外科接受ALTF修复口腔颌面部缺损的患者。我们在术后1、3、6、12和24个月测量ALTF的体积；将术后1个月的皮瓣体积作为基线。主要结局变量为术后3、6、12和24个月时ALTF的残余率，定义为各月当前体积与基线体积之比。主要预测变量为可能与ALTF体积减少相关的临床变量。计算描述性和双变量统计量，设定具有统计学意义的P值≤0.05。
样本包括70名受试者，平均年龄53.8岁（46名男性和24名女性）。术后3、6、12和24个月时相对于基线体积的残余率分别为72.3%、69.0%、67.9%和68.7%。术后放疗的使用（P<0.01）和低体重指数（BMI；P=0.006）与术后ALTF体积减少显著相关。
本研究结果表明，ALTF体积缩小主要发生在术后6个月内，术后放疗和低BMI是体积减少的危险因素。应进行过度矫正以应对ALTF的缩小，术后营养管理对于避免ALTF体积减少很重要。
