Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital; Chang Gung University and Medical College, Taoyuan, Taiwan.
Department of Plastic and Reconstructive Surgery, São José Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
J Reconstr Microsurg. 2022 Oct;38(8):654-663. doi: 10.1055/s-0042-1743165. Epub 2022 Feb 25.
Superficial temporal vessels have been used successfully as recipient vessels for head and neck reconstruction. This study evaluates the impact of several treatment variables on flap failure and take-back rate when using these recipient vessels.
We conducted a retrospective study of all microsurgical reconstructions using superficial temporal vessels as recipient vessels in a period of 10 years. Variables collected included previous treatments (radiotherapy, chemotherapy, neck dissection, free flap reconstruction), type of flaps used (soft tissue, osteocutaneous), and vessel size discrepancy between donor and recipient vessels.
A total of 132 patients were included in the study. The flap success rate was 98.5%. The take-back rate was 10.6%. The most frequent reason for take-back was venous congestion secondary to thrombosis. None of the studied variables was associated with flap failure. Reconstructions using osteocutaneous flaps and vein diameter discrepancy (ratio ≥ 2:1) had significantly higher take-back rates.
Flaps with a significant size discrepancy between donor and recipient veins (ratio ≥ 2:1) and fibula flaps (compared with soft tissue flaps) were associated with a higher risk of take-back. It is crucial to minimize venous engorgement during flap harvest and anastomosis, and limit vein redundancy during flap in-setting.
颞浅血管已成功用作头颈部重建的受区血管。本研究评估了在使用这些受区血管时，多种治疗变量对皮瓣失败和再取回率的影响。
我们对 10 年间使用颞浅血管作为受区血管的所有显微重建进行了回顾性研究。收集的变量包括先前的治疗（放疗、化疗、颈清扫术、游离皮瓣重建）、使用的皮瓣类型（软组织、骨- 肌皮瓣）以及供区和受区血管之间的血管大小差异。
共有 132 例患者纳入研究。皮瓣成功率为 98.5%。再取回率为 10.6%。再取回最常见的原因是血栓引起的静脉充血。研究中的变量均与皮瓣失败无关。使用骨-肌皮瓣和静脉直径差异（比值≥2:1）的重建有更高的再取回率。
供区和受区静脉之间存在明显大小差异（比值≥2:1）和腓骨皮瓣（与软组织皮瓣相比）的皮瓣与更高的再取回风险相关。在皮瓣采集和吻合过程中，务必尽量减少静脉充血，在皮瓣内置入时限制静脉冗余。
