Hing D N, Buncke H J, Alpert B S
Department of Microsurgery, Ralph K. Davies Medical Center, San Francisco, Calif.
Plast Reconstr Surg. 1988 Apr;81(4):534-44. doi: 10.1097/00006534-198804000-00008.
Reconstruction of hand coverage has been limited to flaps with the drawbacks of bulkiness and donor-site morbidity. In contrast, the temporoparietal fascia is a thin, pliable, well-vascularized sheet of tissue available in abundant quantity. It leaves an inconspicuous donor site within the hair-bearing scalp. In addition, microvascular transfer is facilitated by the consistent, reliable, and large-caliber axial superficial temporal vascular supply. The branches of the superficial temporal system provide flexibility in designing axial-pattern flaps. Secondary reconstructive surgery can be safely performed beneath the flap. The intrinsic vascularity of the flap may be useful in revascularizing scarred or irradiated areas. There is also the potential to transfer cranial bone as a composite temporoparietal osteofascial free flap to the hand. There has been partial flap necrosis and permanent alopecia at the donor site in only 1 of 12 patients. We recommend this flap based on our experience in these 12 patients.
手部覆盖重建一直局限于存在臃肿和供区并发症缺点的皮瓣。相比之下，颞顶筋膜是一种薄而柔韧、血供丰富的组织片，数量充足。它在有毛发的头皮内留下不显眼的供区。此外，颞浅血管恒定、可靠且口径大的轴向血供便于进行微血管转移。颞浅系统的分支在设计轴型皮瓣时提供了灵活性。皮瓣下可安全地进行二期重建手术。皮瓣的内在血管化可能有助于对瘢痕或放疗区域进行血管重建。还有可能将颅骨作为复合颞顶骨筋膜游离皮瓣转移至手部。12例患者中仅有1例供区出现部分皮瓣坏死和永久性脱发。基于我们对这12例患者的经验，我们推荐使用这种皮瓣。
