肩胛皮瓣系统在下颌骨重建中的优势。
Advantages of the scapular system in mandibular reconstruction.
作者信息
Wolter Gabrielle L, Swendseid Brian P, Sethuraman Shruthi, Ivancic Ryan, Teknos Theodoros N, Haring Catherine T, Kang Stephen Y, Old Matthew O, Seim Nolan B
机构信息
College of Medicine, Ohio State University, Columbus, Ohio, USA.
Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
出版信息
Head Neck. 2023 Feb;45(2):307-315. doi: 10.1002/hed.27235. Epub 2022 Nov 6.
BACKGROUND
Fibula free flaps (FFF) are often considered the first choice for mandibular reconstruction, but scapular system free flaps (SFF) have increased in popularity due to versatility, donor site advantages, and patient factors.
METHODS
Retrospective chart review of patients undergoing mandibulectomy with FFF or SFF reconstruction from 2016 to 2021.
RESULTS
Hundred and seventy-six patients (FFF n = 145, SFF n = 31) underwent the aforementioned procedures. Mean FFF operative time was 9.47 h versus 9.88 for SFF (p = 0.40). Two-flap reconstructions required 12.65 h versus 10.09 for SFF with soft tissue (p = 0.002). Donor site complications were identified in 65.6% of FFF with skin grafting.
CONCLUSIONS
These findings suggest that SFF requires similar operative time and results in reduced donor site morbidity as compared to FFF. Supine, concurrent harvesting of SFF allows for single-flap harvest with significantly shorter operative time. SFF could be considered a primary option for mandible reconstruction for complex defects and in select patients.
背景
腓骨游离皮瓣（FFF）常被视为下颌骨重建的首选，但肩胛系统游离皮瓣（SFF）因其多功能性、供区优势和患者因素而越来越受欢迎。
方法
对2016年至2021年接受FFF或SFF重建的下颌骨切除术患者进行回顾性病历审查。
结果
176例患者（FFF组n = 145，SFF组n = 31）接受了上述手术。FFF的平均手术时间为9.47小时，而SFF为9.88小时（p = 0.40）。双瓣重建需要时间为12.65小时，而带软组织的SFF为10.09小时（p = 0.002）。65.6%接受植皮的FFF患者出现供区并发症。
结论
这些发现表明，与FFF相比，SFF需要的手术时间相似，且供区发病率更低。仰卧位同时切取SFF可进行单瓣切取，手术时间明显缩短。对于复杂缺损和特定患者，SFF可被视为下颌骨重建的主要选择。
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