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采用游离股前外侧皮瓣修复面部血管瘤患者的放射性损伤

Reconstruction of radiation-induced damage in patients with facial hemangiomas using free anterolateral thigh flap.

作者信息

Sơn Trần Thiết, Nghĩa Phan Tuấn, Trọng Nguyễn Hữu, Việt Dung Phạm Thị, Hồng Thuý Tạ Thị, Runyan Christopher

机构信息

Department of Plastic and Reconstructive Surgery, Hanoi Medical University, Hanoi, Vietnam.

Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam.

出版信息

JPRAS Open. 2025 Jan 10;43:419-427. doi: 10.1016/j.jpra.2025.01.007. eCollection 2025 Mar.

DOI:10.1016/j.jpra.2025.01.007
PMID:39980600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11840491/
Abstract

OBJECTIVE

Radiation therapy to treat hemangiomas is an old method that is no longer used due to its severe side effects. However, in Vietnam, radiotherapy has long been used to treat infantile hemangiomas, which has led to severe sequelae in adulthood. This article shares our experience in reconstructing the sequelae of radiation therapy for facial hemangioma using free anterolateral thigh (ALT) flap.

MATERIALS AND METHODS

Six patients underwent facial lesion reconstruction using different ALT flaps, including volume augmentation, fascial, and thinning flaps.

RESULTS

The largest flap used was 20 × 8 cm and the smallest flap was 11 × 6 cm. All flaps survived completely and no post-operative complications were noted. The patients were highly satisfied with the surgical outcomes, and the aesthetics of the flap were also excellent, with the flap being similar in color to the facial skin.

CONCLUSION

The ALT flap has several advantages, including flexibility in use, diversity in flap components, and minimal impact on the donor site, making it increasingly popular and effective.

摘要

目的

放射治疗血管瘤是一种因副作用严重而不再使用的古老方法。然而,在越南,放射治疗长期以来一直被用于治疗婴儿血管瘤,这导致了成年后的严重后遗症。本文分享我们使用游离股前外侧(ALT)皮瓣修复面部血管瘤放射治疗后遗症的经验。

材料与方法

6例患者使用不同的ALT皮瓣进行面部病变修复,包括容积增加皮瓣、筋膜皮瓣和薄型皮瓣。

结果

使用的最大皮瓣为20×8cm,最小皮瓣为11×6cm。所有皮瓣均完全存活,未观察到术后并发症。患者对手术效果高度满意,皮瓣的美学效果也非常好,皮瓣颜色与面部皮肤相似。

结论

ALT皮瓣具有多种优点,包括使用灵活、皮瓣成分多样以及对供区影响最小,使其越来越受欢迎且有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/362b52422b5c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/279c83015ea9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/a5a9ef0dece7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/362b52422b5c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/279c83015ea9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/a5a9ef0dece7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc6/11840491/362b52422b5c/gr3.jpg

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本文引用的文献

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Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice.首选感觉型股前外侧皮瓣进行下唇重建。
Plast Reconstr Surg Glob Open. 2023 May 22;11(5):e5003. doi: 10.1097/GOX.0000000000005003. eCollection 2023 May.
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Long-term outcomes of low-dose radiotherapy in Kasabach-Merritt syndrome.低剂量放疗治疗卡萨巴赫-梅里特综合征的长期疗效
Radiat Oncol J. 2022 Mar;40(1):45-52. doi: 10.3857/roj.2021.00983. Epub 2022 Mar 22.
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Traumatic loss of total lower lip and chin: The anterolateral thigh flap provides an optimal solution.
下唇及颏部外伤性全层缺损:股前外侧皮瓣提供了最佳解决方案。
JPRAS Open. 2018 Dec 24;19:56-60. doi: 10.1016/j.jpra.2018.12.007. eCollection 2019 Mar.
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Comprehensive Treatment of Facial Deformity Due to Radiotherapy in Rhabdomyosarcoma Patients: Distraction Osteogenesis and Free Flaps Surgical Technique.
J Craniofac Surg. 2019 Jun;30(4):1275-1279. doi: 10.1097/SCS.0000000000005338.
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An experience on primary thinning and secondary debulking of anterolateral thigh flap in head and neck reconstruction.头颈部重建中股前外侧皮瓣的初次减薄和二次修薄经验。
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Prophylaxis and management of acute radiation-induced skin reactions: a systematic review of the literature.急性放射性皮肤反应的预防和处理:文献系统评价。
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Understanding radiation-induced vascular disease.了解辐射诱导的血管疾病。
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8
The anterolateral thigh flap in head and neck reconstruction: "pearls and pitfalls".头颈部重建中的股前外侧皮瓣:“要点与陷阱”
Br J Oral Maxillofac Surg. 2010 Jan;48(1):5-10. doi: 10.1016/j.bjoms.2009.07.026. Epub 2009 Sep 17.
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Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology.预防或减轻放射治疗的晚期副作用:放射生物学与分子病理学的结合
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