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局部全厚皮片的新型设计:桡侧前臂游离皮瓣供区的优化。

Novel design for local full-thickness skin graft: optimizing donor sites of radial forearm free flap.

机构信息

Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, China.

Department of Oral and Maxillofacial Surgery, The Oral and Maxillofacial-Head and Neck Digital Precision Reconstruction Technology Research Center of Guangdong Province, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, China.

出版信息

J Cosmet Dermatol. 2022 Oct;21(10):4595-4604. doi: 10.1111/jocd.14823. Epub 2022 Feb 18.

Abstract

OBJECTIVE

Donor site deformities remain the primary issues after radial forearm free flap (RFFF) translocations. This study introduced a local full-thickness skin graft (FTSG) from an adjacent cutaneous area to manage RFFF donor sites and evaluated the esthetic and functional outcomes post-operatively.

PATIENTS AND METHODS

This was a retrospective study among patients undergoing ablative surgery for head and neck tumors followed by defect reconstruction using a RFFF. The RFFF donor site defects were covered by local FTSGs from the adjacent skins whose harvesting was assisted by a forearm model or traditional FTSGs from abdomen. The color matching degree, surgical scars, ranges of wrist movement, and grip strengths in donor forearms were assessed in two groups at twelve months after surgery.

RESULTS

Patients undergoing local FTSGs recovery exhibited better color matching than those repaired by traditional FTSGs from the abdomen. In forearm model, the local FTSGs width should be less than 22% of the forearm circumference located 5 cm away from the center of Fossa cubitalis. All the local FTSGs transplanted with this technique showed primary or secondary healing.

CONCLUSIONS

This study demonstrated using this innovatively designed local FTSGs to close RFFF donor sites was more advantageous than traditional methods.

摘要

目的

游离前臂皮瓣(RFFF)移植后,供区畸形仍然是主要问题。本研究介绍了一种从相邻皮区切取局部全厚皮片(FTSG)来处理 RFFF 供区的方法,并评估了术后的美观和功能结果。

患者和方法

这是一项回顾性研究,纳入了因头颈部肿瘤行切除术并随后使用 RFFF 进行缺损重建的患者。游离前臂皮瓣供区缺损采用相邻皮肤的局部全厚皮片覆盖,前臂模型或腹部传统全厚皮片协助切取。术后 12 个月,评估两组患者供区前臂的颜色匹配度、手术瘢痕、腕关节活动范围和握力。

结果

接受局部全厚皮片修复的患者颜色匹配度优于接受腹部传统全厚皮片修复的患者。在使用前臂模型时,供区皮片的宽度应小于距肘窝中心 5cm 处前臂周径的 22%。采用该技术移植的所有局部全厚皮片均一期或二期愈合。

结论

本研究表明,使用这种创新设计的局部全厚皮片来封闭 RFFF 供区比传统方法更有优势。

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