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头颈部重建中的三角胸肌皮瓣。

Deltopectoral Flap in Head and Neck Reconstruction.

机构信息

Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy.

出版信息

Medicina (Kaunas). 2024 Oct 2;60(10):1615. doi: 10.3390/medicina60101615.

Abstract

: The deltopectoral (DP) flap represents a reconstructive option for the head and neck. It is a fasciocutaneous flap raised from the anterior chest wall below the clavicle. Its role partially declined with the arise of free flaps. However, it still remains a valid option in patients that could not undergo a reconstruction with free flaps. The aim of this retrospective study was to evaluate the role of the DP flap in head and neck reconstruction, with a focus on surgical outcomes and complications. : Thirty-one patients who underwent head and neck reconstruction with DP flap were included in the study. The delayed technique was not used in any procedure to harvest the flap beyond the deltopectoral groove. The patients' characteristics, the recipient site, the closure of the donor site, and the flap-related complications were recorded. : The median time to autonomization of DP flap was 23 days. Postoperative complications were observed in 10 subjects (32.3%). A partial necrosis was seen in five patients (16.1%), while a complete necrosis developed only in one case (3.2%). The diabetes mellitus was the only parameter associated with postoperative complications. In particular, the percentage of necrosis in subjects with or without diabetes was 66.7% and 8.0%, respectively. : The DP has a wide range of applications in head and neck reconstruction, and a low complication rate can be observed. The delayed technique does not necessarily need to be applied, and the flap can be extended beyond the deltopectoral groove when necessary. However, patients with diabetes mellitus have a higher risk of postoperative necrosis of the distal portion of the flap.

摘要

胸三角皮瓣(DP)是头颈部重建的一种选择。它是一种从锁骨下方的前胸壁提起的筋膜皮瓣。随着游离皮瓣的出现,其作用部分下降。然而,对于无法进行游离皮瓣重建的患者,它仍然是一种有效的选择。本回顾性研究旨在评估 DP 皮瓣在头颈部重建中的作用,重点关注手术结果和并发症。

研究纳入了 31 例接受 DP 皮瓣头颈部重建的患者。在任何手术中,均未使用延迟技术来采集超过胸三角沟的皮瓣。记录了患者的特征、受区部位、供区部位的闭合以及与皮瓣相关的并发症。

DP 皮瓣自主化的中位时间为 23 天。10 例患者(32.3%)观察到术后并发症。5 例患者(16.1%)出现部分坏死,仅 1 例(3.2%)出现完全坏死。糖尿病是唯一与术后并发症相关的参数。具体而言,有糖尿病的患者与无糖尿病的患者的坏死比例分别为 66.7%和 8.0%。

DP 在头颈部重建中有广泛的应用,且可观察到较低的并发症发生率。不一定需要应用延迟技术,必要时可以将皮瓣延伸到胸三角沟以外。然而,患有糖尿病的患者有更高的远端皮瓣术后坏死风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d8c/11509381/c18817454dff/medicina-60-01615-g001.jpg

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