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肢体原发性皮肤恶性肿瘤广泛局部切除术后的静脉皮瓣重建

Venous Flap Reconstruction following Wide Local Excision for Primary Cutaneous Malignancies in Extremities.

作者信息

Deguchi Ayaka, Motomura Hisashi, Hatano Takaharu, Fujikawa Heishiro, Maeda Shusaku

机构信息

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka City University, Osaka, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2022 Mar 22;10(3):e4220. doi: 10.1097/GOX.0000000000004220. eCollection 2022 Mar.

Abstract

UNLABELLED

Cutaneous malignancies in the extremities are relatively common, and radical treatment such as ray amputation was performed for certain advanced skin cancer cases in the past. The concept of surgical treatment of primary cutaneous malignant tumor has gradually changed, and preservation of the extremity by performing the appropriate excision and reconstruction became possible. Various reconstructive methods after the resection of malignant tumors such as skin grafts, local flaps, and free flaps, including perforator flaps have been noted. Due to limitations and some disadvantages of these reconstructive materials for extremities, the arterialized venous flap arose as an alternative method. The arterialized venous flap, which has arterial inflow through an afferent vein perfusing the flap and venous outflow through the efferent veins, is considered to function as a great reconstructive material for distal extremities. Although efficacy of this flap has been noted in the past, usage of the flap considering the oncological aspects and application of the flap to the toes and feet have never been reported.

METHODS

Thirteen reconstructive cases from October 2005 to October 2016 using venous flaps after excision of primary cutaneous malignancy in the distal extremities were performed in our institution.

RESULTS

For all cases, satisfactory functional and cosmetic outcomes were observed.

CONCLUSIONS

Reconstruction using the arterialized venous flap is considered a reliable and versatile method. Careful application of this flap satisfies functional, cosmetic, and oncological aspects of all distal extremities with cutaneous malignancy.

摘要

未标注

肢体皮肤恶性肿瘤相对常见,过去对于某些晚期皮肤癌病例会采用诸如截肢等根治性治疗方法。原发性皮肤恶性肿瘤的外科治疗理念已逐渐改变,通过进行适当的切除和重建来保留肢体成为可能。已注意到切除恶性肿瘤后的各种重建方法,如皮肤移植、局部皮瓣和游离皮瓣,包括穿支皮瓣。由于这些用于肢体的重建材料存在局限性和一些缺点,动脉化静脉皮瓣应运而生作为一种替代方法。动脉化静脉皮瓣通过一条传入静脉有动脉血流灌注皮瓣,并通过传出静脉有静脉流出,被认为是用于远端肢体的一种很好的重建材料。尽管过去已注意到这种皮瓣的功效,但从未有关于从肿瘤学角度考虑使用该皮瓣以及将其应用于脚趾和足部的报道。

方法

我们机构在2005年10月至2016年10月期间对13例远端肢体原发性皮肤恶性肿瘤切除术后使用静脉皮瓣进行重建的病例进行了研究。

结果

所有病例均观察到满意的功能和美容效果。

结论

使用动脉化静脉皮瓣进行重建被认为是一种可靠且通用的方法。谨慎应用该皮瓣可满足所有远端肢体皮肤恶性肿瘤在功能、美容和肿瘤学方面的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/309a/8939925/f597a72dcb7b/gox-10-e4220-g001.jpg

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