Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Mar;133(3):277-281. doi: 10.1016/j.oooo.2021.06.018. Epub 2021 Jul 5.
Plate exposure remains one of the most serious complications of oromandibular reconstruction. The purpose of this study was to investigate the effect of wrapping reconstruction plates with anterolateral thigh (ALT) free flaps as a way to prevent plate exposure.
A total of 91 patients with composite oromandibular defects who underwent surgical reconstruction using a reconstruction plate in conjunction with an ALT musculocutaneous flap were recruited. The participants were divided into 2 groups, based on whether the plate was wrapped with or covered by the ALT flap.
The incidence of plate exposure in the experimental group (17%) was significantly lower than that of the control group (43.1%; P < .0001). The mean time from reconstruction until plate exposure in the experimental group was 19.4 ± 23.6 months, whereas the mean time in the control group was 12.3 ± 9.1 months. In the logistic regression model for the occurrence of plate exposure, the only factor found to be associated with plate exposure was how the ALT flap was used (P = .026).
The results of the present study indicate that wrapping the reconstruction plate with an ALT flap decreased the incidence of plate exposure in patients with oromandibular defects.
板暴露仍然是口颌重建中最严重的并发症之一。本研究旨在探讨包裹重建板用股前外侧（ALT）游离皮瓣的方法，以防止板暴露。
共招募 91 例复合口颌缺损患者，采用重建板联合 ALT 肌皮瓣进行手术重建。根据板是否用 ALT 皮瓣包裹或覆盖，将参与者分为两组。
实验组（17%）板暴露的发生率明显低于对照组（43.1%；P<.0001）。实验组重建后至板暴露的平均时间为 19.4±23.6 个月，而对照组为 12.3±9.1 个月。在板暴露发生的逻辑回归模型中，唯一与板暴露相关的因素是 ALT 皮瓣的使用方式（P=.026）。
本研究结果表明，用 ALT 皮瓣包裹重建板可降低口颌缺损患者板暴露的发生率。
