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ALT穿支皮瓣在头颈部重建中的作用。

Role of ALT Perforator Flaps in Head and Neck Reconstruction.

作者信息

Khowala Sagarika, Sham M E, Reddy Thyagraj, Menon Suresh, Archana S

机构信息

Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, India.

出版信息

J Maxillofac Oral Surg. 2025 Feb;24(1):172-187. doi: 10.1007/s12663-023-01990-9. Epub 2023 Aug 31.

Abstract

BACKGROUND

The anterolateral thigh flap is a versatile flap that offers many advantages. These include a long and reliable pedicle that enables a wide arc of rotation, the possibility to harvest a large skin area, raising the flap with underlying fascia and minimal donor site morbidity. The purpose of this study is to show better esthetics and function with the use of ALT perforator flap in head and neck region. It is a large prospective case study done in our institute with regular follow-up which shows the outcomes of ALT flap.

MATERIALS AND METHOD

From 2020 to 2022, hundred patients were reconstructed with anterolateral thigh flap. The flap was used for reconstruction in head and neck region. The patient group consisted of 53 males and 47 females. The age range was 30-90 years with a mean age of 61 years. Patients who had extensive soft tissue defect in the head and neck and had been reconstructed by free ALT flap have been reported. Flap data (type, length, and width), duration of flap elevation, donor-site morbidity, post-operative complications, and follow-up data including aesthetic and functional outcome were recorded.

RESULTS

We experienced no flap loss. The donor site was closed directly in twenty-eight out of eighty patients, and the remaining twenty patients were closed by split thickness skin grafting. Satisfactory aesthetic and functional outcome were achieved in all patients.

CONCLUSION

Our experience illustrates the versatility in the clinical application of the anterolateral thigh flap. The many advantages of the flap, such as the long and reliable pedicle, a large area of skin that can be harvested, the potential to supercharge the flap and the minimal donor site morbidity, highlight the diversity of defects that can be reconstructed using this flap.

摘要

背景

股前外侧皮瓣是一种用途广泛的皮瓣,具有诸多优点。这些优点包括有一条长且可靠的蒂,可实现大范围的旋转弧度,能够切取大面积的皮肤,可连带深筋膜掀起皮瓣且供区并发症少。本研究的目的是展示在头颈部区域使用股前外侧穿支皮瓣能获得更好的美学效果和功能。这是一项在我们研究所进行的大型前瞻性病例研究,并进行了定期随访,展示了股前外侧皮瓣的治疗效果。

材料与方法

2020年至2022年期间,100例患者采用股前外侧皮瓣进行了重建手术。该皮瓣用于头颈部区域的重建。患者组包括53名男性和47名女性。年龄范围为30 - 90岁,平均年龄61岁。报告了头颈部存在广泛软组织缺损并通过游离股前外侧皮瓣进行重建的患者情况。记录了皮瓣数据(类型、长度和宽度)、皮瓣掀起时间、供区并发症、术后并发症以及包括美学和功能结果的随访数据。

结果

我们未出现皮瓣坏死情况。80例患者中有28例供区直接缝合,其余20例患者采用中厚皮片移植进行闭合。所有患者均获得了满意的美学和功能效果。

结论

我们的经验说明了股前外侧皮瓣在临床应用中的多功能性。该皮瓣的诸多优点,如长且可靠的蒂、可切取的大面积皮肤、皮瓣增压的潜力以及最小的供区并发症,突出了使用该皮瓣可重建的缺损类型的多样性。

相似文献

1
Role of ALT Perforator Flaps in Head and Neck Reconstruction.ALT穿支皮瓣在头颈部重建中的作用。
J Maxillofac Oral Surg. 2025 Feb;24(1):172-187. doi: 10.1007/s12663-023-01990-9. Epub 2023 Aug 31.

本文引用的文献

3
Perforator flaps: the next step in the reconstructive ladder?
Br J Oral Maxillofac Surg. 2015 Nov;53(9):787-95. doi: 10.1016/j.bjoms.2015.03.020. Epub 2015 Jul 15.
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Perforator Flap versus Conventional Flap.穿支皮瓣与传统皮瓣
J Korean Med Sci. 2015 May;30(5):514-22. doi: 10.3346/jkms.2015.30.5.514. Epub 2015 Apr 15.
5
Perforator flaps in head and neck reconstruction.穿支皮瓣在头颈部重建中的应用。
Semin Plast Surg. 2010 Aug;24(3):237-54. doi: 10.1055/s-0030-1263066.
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Free flaps: outcomes and complications in head and neck reconstructions.游离皮瓣:头颈部重建的结果和并发症。
J Craniomaxillofac Surg. 2009 Dec;37(8):438-42. doi: 10.1016/j.jcms.2009.05.003. Epub 2009 Jun 23.

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