Ford C N, Anderson A G
Arch Otolaryngol. 1983 Jul;109(7):449-53. doi: 10.1001/archotol.1983.00800210025005.
Utilization of advancement flaps to cover facial defects is potentially limited by the secondary distortion of adjacent anatomical landmarks, expansion of any residual lesion, and the vascular embarrassment of wound closure under tension. In this study, advancement flaps are raised in piglets, and the first stage in the serial excision of a hypothetical skin lesion is simulated. It is demonstrated that undermining of the lesion-bearing skin results in expansion of the lesion and is counterproductive. If, however, a separate layer of hypodermis and fascia is mobilized deep to the lesion and sutured to the advancing flap, skin closure can be accomplished with minimal tension. This results in maximal recruitment of the advancement flap and minimal expansion of the residual lesion as the defect is bridged.
推进皮瓣用于覆盖面部缺损可能受到相邻解剖标志的继发性变形、任何残留病变的扩大以及张力下伤口闭合时的血管受压等因素的限制。在本研究中，在仔猪身上掀起推进皮瓣，并模拟对一个假设的皮肤病变进行连续切除的第一阶段。结果表明，对有病变的皮肤进行潜行分离会导致病变扩大，适得其反。然而，如果在病变深部分离出一层单独的皮下组织和筋膜并缝合到推进皮瓣上，皮肤闭合可以在最小张力下完成。这样，在桥接缺损时，推进皮瓣的募集最大化，残留病变的扩大最小化。
