Wang Changquan, Huang Tianbin, Guan Shanbin, Huang Guangru, Cheng Xiaoyuan, Lu Liushan
Department of Head and Neck Surgery，Wuzhou Red Cross Hospital，Wuzhou，543002，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jun;39(6):534-541. doi: 10.13201/j.issn.2096-7993.2025.06.007.
To compare the clinical outcomes of reconstruction of oral and maxillofacial soft tissue defects using superficial circumflex iliac artery perforator flap （SCIA PF） and radial forearm free flap （RFF）. A retrospective analysis was conducted on 90 patients with head, neck, and maxillofacial tumors who were treated in our department from June 2019 to January 2024. Patients were divided into two groups based on the surgical method used: the SCIA group（=45）, who underwent reconstruction with SCIA PF, and the RFF group（=45）, who received RFF reconstruction. Six months postoperatively, clinical efficacy was evaluated by comparing flap swelling, flap survival rate, and patient satisfaction. Oral function was assessed using standardized scoring systems before surgery, at 1 week, 3 months, and 6 months post-surgery. Hemorheological parameters, including high-shear viscosity（shear rate 200/s）, low-shear viscosity（shear rate 30/s）, plasma viscosity, erythrocyte aggregation index, and erythrocyte sedimentation rate（ESR）, were also measured at each time point. Compared with the RFF group, the SCIA group showed significantly larger flap size, longer flap harvesting and reconstruction times, earlier nasogastric tube removal and oral intake initiation, higher scores in all aspects of oral function, reduced flap edema and faster resolution, higher flap survival rates, and greater overall satisfaction （all <0.05）. During the follow-up period （preoperative, 1 week, 3 months, and 6 months post-surgery）, hemorheological indices including high-and low-shear viscosity, plasma viscosity, erythrocyte aggregation index, and ESR progressively decreased in the SCIA group （<0.05）. In the RFF group, these parameters improved significantly by 6 months postoperatively compared with preoperatively and 1-week postoperatively, with a notable decrease in erythrocyte aggregation index at 6 months （<0.05）. Compared with RFF, SCIA PF provides larger flaps, better functional recovery, higher patient satisfaction, improved flap survival, fewer complications, and more favorable hemorheological profiles following reconstructive surgery for oral and maxillofacial defects.
比较旋髂浅动脉穿支皮瓣（SCIA PF）和游离桡侧前臂皮瓣（RFF）修复口腔颌面部软组织缺损的临床效果。对2019年6月至2024年1月在我科治疗的90例头颈部及口腔颌面部肿瘤患者进行回顾性分析。根据手术方法将患者分为两组：SCIA组（n = 45），采用SCIA PF进行修复；RFF组（n = 45），接受RFF修复。术后6个月，通过比较皮瓣肿胀情况、皮瓣成活率和患者满意度评估临床疗效。术前、术后1周、3个月和6个月使用标准化评分系统评估口腔功能。在每个时间点还测量血液流变学参数，包括高切黏度（剪切速率200/s）、低切黏度（剪切速率30/s）、血浆黏度、红细胞聚集指数和红细胞沉降率（ESR）。与RFF组相比，SCIA组皮瓣面积明显更大，皮瓣切取和修复时间更长，鼻饲管拔除和开始经口进食更早，口腔功能各方面评分更高，皮瓣水肿减轻且消退更快，皮瓣成活率更高，总体满意度更高（均P < 0.05）。在随访期间（术前、术后1周、3个月和6个月），SCIA组血液流变学指标包括高切黏度、低切黏度、血浆黏度、红细胞聚集指数和ESR逐渐下降（P < 0.05）。在RFF组，与术前和术后1周相比，这些参数在术后6个月显著改善，6个月时红细胞聚集指数显著降低（P < 0.05）。与RFF相比，SCIA PF在修复口腔颌面部缺损的重建手术中提供更大的皮瓣、更好的功能恢复、更高的患者满意度、更高的皮瓣成活率、更少的并发症以及更有利的血液流变学特征。
