Eguchi T, Kawaguchi K, Sato K, Hamada Y
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Int J Oral Maxillofac Surg. 2023 May;52(5):539-542. doi: 10.1016/j.ijom.2022.09.036. Epub 2022 Oct 13.
Although the pectoralis major myocutaneous (PMMC) flap is among the useful reconstructive materials following oral cancer ablation, this flap has an unstable blood circulation that could result in partial necrosis of the skin paddle. This report describes the usefulness of indocyanine green angiography (ICGA) to achieve complete engraftment of the PMMC flap. Five patients with oral cancer underwent reconstruction with a PMMC flap after cancer ablation. During the skin paddle design and flap elevation, the blood supply to the flap was assessed by ICGA. Areas of the skin paddle that showed no ICG fluorescence were excised. Consequently, prior to transfer to the recipient site, the blood supply to all flaps was confirmed with indocyanine green visible at the edge of the skin paddle, and complete engraftment was achieved without partial necrosis. Based on the results observed, ICGA would make a useful contribution to complete engraftment of the PMMC flap.
尽管胸大肌肌皮瓣（PMMC瓣）是口腔癌切除术后有用的重建材料之一，但该皮瓣血液循环不稳定，可能导致皮岛部分坏死。本报告描述了吲哚菁绿血管造影（ICGA）对实现PMMC瓣完全植入的作用。5例口腔癌患者在癌症切除后接受了PMMC瓣重建。在皮岛设计和皮瓣掀起过程中，通过ICGA评估皮瓣的血供。切除无ICG荧光的皮岛区域。因此，在转移至受区之前，通过皮岛边缘可见的吲哚菁绿确认了所有皮瓣的血供，实现了完全植入且无部分坏死。基于观察结果，ICGA将对PMMC瓣的完全植入起到有益作用。
