Hewitt Lyndel, Yabe Takako, Wykes James, McAndrew Darryl J, Clark Jonathan R, Ashford Bruce G
Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.
Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.
Plast Reconstr Surg Glob Open. 2021 Oct 4;9(10):e3846. doi: 10.1097/GOX.0000000000003846. eCollection 2021 Oct.
Information about the use and donor site morbidity of periosteal free flaps in head and neck reconstruction is limited. The aim of this study was to examine potential periosteal free flap donor sites with respect to their dimensions, tissue and pedicle characteristics, and predicted donor site morbidity in a cadaveric model. The following cadaveric periosteal specimens with a vascular pedicle were harvested using standard surgical approaches: skull, chest wall, sternum, scapula, iliac crest, femur, and humerus. Data relating to the periosteum size and quality, vascular pedicle, surgical factors, feasibility of use, and the potential donor-site morbidity were recorded. One female (age: 78 years, height: 152 cm) and one male (age: 65 years, height: 186 cm) cadaver were used for flap harvest. The skull, chest wall, scapula, and femur were suitable in terms of the size of the periosteum harvested. The procedure to remove the periosteum from the scalp, chest wall, and scapula had the least predicted donor-site morbidity. The pedicle length and vessel caliber from the periosteal flaps were most favorable from the skull, scapula, and iliac crest. Considering all factors, the periosteum harvested from the skull and scapula were the most promising.
关于骨膜游离皮瓣在头颈部重建中的应用及供区并发症的信息有限。本研究的目的是在尸体模型中，研究潜在的骨膜游离皮瓣供区的尺寸、组织和蒂部特征，以及预测的供区并发症。使用标准手术方法采集以下带有血管蒂的尸体骨膜标本：颅骨、胸壁、胸骨、肩胛骨、髂嵴、股骨和肱骨。记录与骨膜大小和质量、血管蒂、手术因素、使用可行性以及潜在供区并发症相关的数据。使用一具女性尸体（年龄：78岁，身高：152厘米）和一具男性尸体（年龄：65岁，身高：186厘米）进行皮瓣采集。就采集的骨膜大小而言，颅骨、胸壁、肩胛骨和股骨是合适的。从头皮、胸壁和肩胛骨上剥离骨膜的操作预测的供区并发症最少。骨膜皮瓣的蒂长度和血管口径在颅骨、肩胛骨和髂嵴处最为理想。综合考虑所有因素，从颅骨和肩胛骨采集的骨膜最具前景。
