Franklin J D, Shack R B, Stone J D, Madden J J, Lynch J B
Am J Surg. 1980 Oct;140(4):492-8. doi: 10.1016/0002-9610(80)90198-1.
Microvascular reconstruction of the mandible and soft tissues using the composite groin flap is ideal in selected patients. No other available bone so closely approximates the mandible in both thickness and curvature as does the iliac crest. The soft tissues are available for reconstruction and may allow the surgeon to avoid a second flap, except in cases where both lining and cover are needed. The deep circumflex artery is of generous size, usually 2 to 2.5 mm in diameter, allowing greater reliability in the microvascular anastomoses. The flap has a fairly long vascular predicle, 6 to 8 cm. The ability of this flap to withstand irradiation and infection because of its blood supply permits early institution of postoperative radiotherapy and prevents bone loss due to small intraoral wound dehisicence or total flap loss. Although the donor site requires extensive dissection, it can be closed primarily, eliminating the need for skin grafts or other flaps. As further experience is gained with this flap, both the functional and cosmetic results should be improved. In patients undergoing resection of the remaining portion of the mandible, the symphysis or the anterior portion of the mandible, a procedure of this type should be done primarily to prevent deformity and to minimize disability for the patient.
对于选定的患者，使用复合腹股沟皮瓣进行下颌骨和软组织的微血管重建是理想的。没有其他可用的骨在厚度和曲率上能像髂嵴那样与下颌骨如此接近。软组织可用于重建，并且除了需要衬里和覆盖物的情况外，可能使外科医生无需使用第二个皮瓣。旋股外侧动脉管径粗大，通常直径为2至2.5毫米，这使得微血管吻合更具可靠性。该皮瓣有相当长的血管蒂，长6至8厘米。由于其血液供应，该皮瓣耐受放疗和感染的能力允许早期进行术后放疗，并防止因口腔内小伤口裂开或皮瓣完全坏死导致的骨质流失。尽管供区需要广泛的解剖，但可以直接缝合，无需植皮或使用其他皮瓣。随着对该皮瓣的经验积累，功能和美容效果都应得到改善。对于接受下颌骨剩余部分、下颌骨联合部或下颌骨前部切除的患者，应首选这种手术方式，以防止畸形并将患者的残疾程度降至最低。
