Li Shuai, Huang Shuojin, Cao Congyuan, Tang Dongxiao, He Qianting, Wang Anxun
Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, Nanning, China.
Heliyon. 2024 Jul 14;10(14):e34613. doi: 10.1016/j.heliyon.2024.e34613. eCollection 2024 Jul 30.
This study aimed to examine the feasibility of the dovetailing skin incision design of radial forearm free flap (RFFF) for closing forearm wounds and performing maxillofacial reconstruction.
A total of 27 patients were divided into two groups. In the dovetail group (n = 16), forearm wounds were closed primarily and maxillofacial defects were reconstructed by dovetail RFFF. In the conventional group (n = 11), forearm wounds were closed by skin grafts from the abdomen or mattress suturing, and maxillofacial defects were reconstructed by conventional RFFF. Information on the healing time of the forearm wound, length of postsurgical hospitalization, esthetic assessments, and complications associated with the forearm wound and the maxillofacial region was collected at least 6 months postoperatively.
The average size of the flap in the dovetail group was smaller than that in the conventional group ( = 0.134), and average healing time of the forearm wound in dovetail group was significantly shorter than that in conventional group ( = 0.000). Comparing with the conventional group, there were more cases in the dovetail group demonstrating decreased sensitivity ( = 1.000). Esthetic assessments of forearm wound and maxillofacial reconstructions in the dovetail group were significantly higher than that in the conventional group ( = 0.000).
Closure of forearm wounds and maxillofacial defects using dovetail design was found to be a feasible alternative to the conventional design.
本研究旨在探讨前臂桡侧游离皮瓣（RFFF）的燕尾形皮肤切口设计用于闭合前臂伤口及进行颌面重建的可行性。
将27例患者分为两组。燕尾形组（n = 16），前臂伤口一期闭合，采用燕尾形RFFF进行颌面缺损重建。传统组（n = 11），前臂伤口采用腹部皮肤移植或褥式缝合闭合，采用传统RFFF进行颌面缺损重建。术后至少6个月收集前臂伤口愈合时间、术后住院时间、美学评估以及与前臂伤口和颌面部相关的并发症等信息。
燕尾形组皮瓣平均大小小于传统组（P = 0.134），燕尾形组前臂伤口平均愈合时间显著短于传统组（P = 0.000）。与传统组相比，燕尾形组感觉减退的病例更多（P = 1.000）。燕尾形组前臂伤口及颌面重建的美学评估显著高于传统组（P = 0.000）。
使用燕尾形设计闭合前臂伤口及颌面缺损被发现是传统设计的一种可行替代方案。
