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评估游离皮瓣显微手术供区并发症及其对生活质量的影响:综述

Assessing Donor Site Morbidity and Impact on Quality of Life in Free Flap Microsurgery: An Overview.

作者信息

Hodea Florin-Vlad, Hariga Cristian-Sorin, Bordeanu-Diaconescu Eliza-Maria, Cretu Andrei, Dumitru Catalina-Stefania, Ratoiu Vladut-Alin, Lascar Ioan, Grosu-Bularda Andreea

机构信息

Department 11, Discipline Plastic and Reconstructive Surgery, Bucharest Clinical Emergency Hospital, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania.

Clinic of Plastic Surgery and Reconstructive Microsurgery, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania.

出版信息

Life (Basel). 2024 Dec 30;15(1):36. doi: 10.3390/life15010036.

Abstract

Donor site morbidity remains a significant concern in free flap microsurgery, with implications that extend beyond immediate postoperative outcomes to affect patients' long-term quality of life. This review explores the multi-faceted impact of donor site morbidity on physical, psychological, social, and occupational well-being, synthesizing findings from the existing literature. Particular attention is given to the functional limitations, sensory deficits, aesthetic outcomes, and chronic pain associated with commonly utilized free flaps. Advancements in surgical techniques, including nerve-sparing and muscle-sparing methods, as well as innovations, like perforator flaps, have demonstrated the potential to mitigate these morbidities. Furthermore, the integration of regenerative medicine strategies, such as stem cell therapy and fat grafting, and technological innovations, including virtual reality rehabilitation and biofeedback devices, has shown promise in enhancing recovery and minimizing long-term complications. Despite these advances, challenges persist in standardizing QoL assessments and optimizing donor site management. This review emphasizes the need for a holistic, patient-centered approach in reconstructive microsurgery, advocating for further research to refine current strategies, improve long-term outcomes, and develop robust tools for QoL evaluation. By addressing these gaps, reconstructive surgeons can better align surgical objectives with the comprehensive well-being of their patients.

摘要

供区并发症仍然是游离皮瓣显微外科手术中一个重大问题,其影响不仅限于术后即刻结果,还会影响患者的长期生活质量。本综述探讨了供区并发症对身体、心理、社会和职业健康的多方面影响,综合了现有文献的研究结果。特别关注了与常用游离皮瓣相关的功能限制、感觉缺陷、美学效果和慢性疼痛。手术技术的进步,包括保留神经和保留肌肉的方法,以及穿支皮瓣等创新技术,已显示出减轻这些并发症的潜力。此外,再生医学策略的整合,如干细胞治疗和脂肪移植,以及技术创新,包括虚拟现实康复和生物反馈设备,在促进恢复和减少长期并发症方面已显示出前景。尽管有这些进展,但在标准化生活质量评估和优化供区管理方面仍存在挑战。本综述强调在重建显微外科手术中需要采取以患者为中心的整体方法,倡导进一步研究以完善当前策略、改善长期结果并开发强大的生活质量评估工具。通过填补这些空白,重建外科医生可以更好地使手术目标与患者的全面健康状况保持一致。

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