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带蒂原位刃厚皮片游离移植术,一种替代远位刃厚皮片游离移植术的方法。

Radially Pedicled In-Situ Split-Thickness Skin Grafts, an Alternative to Distal Split-Thickness Skin Grafts.

机构信息

Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, China.

Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

出版信息

Otolaryngol Head Neck Surg. 2024 Jan;170(1):61-68. doi: 10.1002/ohn.521. Epub 2023 Sep 13.

Abstract

OBJECTIVE

This study aimed to introduce a novel radially pedicled in-situ split-thickness skin graft (STSG). The morbidity, esthetic, and functional outcomes of the radially pedicled in-situ STSG were in comparison with those of the distal STSG.

STUDY DESIGN

Retrospective analysis.

SETTING

A single-institution review.

METHODS

Seventy patients with oral cancer who underwent radical surgical resection and simultaneous radial forearm free flap (RFFF) reconstruction from July 2021 to March 2022 were included. De-epithelialized RFFFs and traditional RFFFs were used to repair oral defects of 35 patients in Group A and Group B, respectively, while radially pedicled in-situ STSGs and distal STSGs taken from abdomens were used to repair donor site defects in the above groups, respectively. Patient demographics, wound healing complications, and esthetic and functional outcomes of the forearms were compared between the 2 groups.

RESULTS

No significant difference between Group A and Group B was observed in terms of donor site and recipient site complications. The esthetic outcome was superior in Group A compared to Group B (P = .011). The extension range, sensation, and pinch strength of operated forearms were significantly reduced in both groups after surgery (P < .05), however, intergroup differences were not observed.

CONCLUSION

Taken together, our results suggest that radially pedicled in-situ STSG is an applicable technique for direct closure and better esthetic outcomes in the forearm donor site.

摘要

目的

本研究旨在介绍一种新的游离桡动脉穿支皮瓣原位分块皮片移植术(in-situ split-thickness skin graft,ISTSG)。将桡动脉穿支皮瓣原位 STSG 的发病率、美观和功能结果与传统远端 STSG 进行比较。

研究设计

回顾性分析。

设置

单机构回顾。

方法

2021 年 7 月至 2022 年 3 月,纳入 70 例接受根治性手术切除和同时游离前臂桡动脉皮瓣(radial forearm free flap,RFFF)重建的口腔癌患者。脱细胞化的 RFFF 和传统的 RFFF 分别用于修复 A 组和 B 组 35 例患者的口腔缺损,而取自腹部的游离桡动脉穿支皮瓣原位 STSG 和远端 STSG 分别用于修复上述两组的供区缺损。比较两组患者的一般资料、伤口愈合并发症以及前臂的美观和功能结果。

结果

A 组和 B 组供区和受区并发症之间无显著差异。与 B 组相比,A 组的美学结果更优(P=0.011)。两组术后前臂的伸展范围、感觉和捏力均显著降低(P<0.05),但组间差异无统计学意义。

结论

综上所述,我们的研究结果表明,游离桡动脉穿支皮瓣原位 STSG 是一种适用于直接闭合和改善前臂供区美观效果的技术。

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