Hanson-Viana Erik, Rojas-Ortiz Jorge, Rendón-Medina Marco A, Pacheco-López Ricardo C, Ríos-Lara López Luciano R, Palacios-Juárez Julio
Department of Plastic and Reconstructive Surgery, The Hospital General Dr. Rubén Leñero, Mexico City, Mexico.
Department of Plastic and Reconstructive Surgery, Hospital Ángeles Lomas, Mexico City, Mexico.
Plast Reconstr Surg Glob Open. 2021 Mar 30;9(3):e3409. doi: 10.1097/GOX.0000000000003409. eCollection 2021 Mar.
Since the description of superficial fascia flap harvesting, a new window of opportunity has been open in obese patients, where a higher subcutaneous thickness of tissue is present. To our knowledge, the impact of body mass index on superficial fascial flaps has not been reported.
We recruited 122 patients from April 2019 to January 2020. From these patients, the 3 most common thinned flaps were selected: the superficial circumflex iliac perforator flap; the anterolateral thigh flap at the perforator A, B, and C; and the thoracodorsal flap. Two vertical measures were registered: the distance from the skin to the superficial fascia, and from this point to the deep fascia.
The average flap measurement presented here was within the range, as previous clinical studies. The superficial fatty layer thickness in the superficial circumflex iliac perforator and anterolateral thigh flap was somewhat similar in thickness between overweight and obese patients, showing a minimal increase with higher body mass index. The anterolateral thigh flap was found thicker among women, and no statistical difference was shown between age groups in any of the flaps.
A better understanding of the fat layers' thickness will result in better planning, minimizing secondary debulking procedures, decreasing operative time, and reducing general complications among obese patients. Thus, a better understanding of flap structure and physiology in obese patients will lower complications and give more predictable results.
自从描述了浅筋膜瓣的切取方法后，肥胖患者就迎来了新的机遇，因为他们皮下组织厚度更大。据我们所知，体重指数对浅筋膜瓣的影响尚未见报道。
我们在2019年4月至2020年1月期间招募了122例患者。从这些患者中，选取了3种最常见的变薄皮瓣：旋髂浅动脉穿支皮瓣；穿支A、B和C处的股前外侧皮瓣；以及胸背皮瓣。记录了两个垂直测量值：从皮肤到浅筋膜的距离，以及从该点到深筋膜的距离。
此处呈现的皮瓣平均测量值在之前临床研究的范围内。超重和肥胖患者的旋髂浅动脉穿支皮瓣和股前外侧皮瓣的浅脂肪层厚度在某种程度上相似，随着体重指数升高仅略有增加。发现股前外侧皮瓣在女性中更厚，且在任何皮瓣的不同年龄组之间均未显示出统计学差异。
更好地了解脂肪层厚度将有助于更好地进行手术规划，尽量减少二次减容手术，缩短手术时间，并减少肥胖患者的总体并发症。因此，更好地了解肥胖患者皮瓣的结构和生理状况将降低并发症并产生更可预测的结果。
