Schliephake H, Schmelzeisen R, Neukam F W
Department of Oral and Maxillofacial Surgery, Medical University of Hannover, Germany.
J Oral Maxillofac Surg. 1994 Dec;52(12):1247-52. doi: 10.1016/0278-2391(94)90045-0.
The aim of this study was to determine the blood flow and the cutaneous sensibility of flaps after the repair of tumor-related defects of the facial skin.
Fifty restorations (27 local flaps, 6 island flaps, 7 free skin grafts, and 10 microvascular grafts) were examined using laser Doppler flowmetry, two-point discrimination, and a pain and thermal sensibility testing device. The average postoperative interval was 62 months. Measurements were performed on the flap surface, the donor site, and the contralateral areas corresponding to the donor site and the former defect. Paired t-tests were used to assess statistically significant differences between the sites of measurement.
Results showed a rate of both blood flow and two-point discrimination on the surface of local flaps and island flaps that was not statistically different from the corresponding area of the unoperated side. Free skin grafts exhibited incomplete restoration of thermal sensibility and increased blood flow rates compared with the donor site. Large microvascular flaps showed complete loss of cutaneous sensibility in six cases, whereas partial restitution without reproducible two-point discrimination was found in the remaining patients after an average interval of 39 months. Flowmetry rates of microvascular flaps corresponded to those of the donor site and were significantly lower than those of the recipient site in the head and neck area.
本研究旨在确定面部皮肤肿瘤相关缺损修复后皮瓣的血流情况和皮肤感觉。
使用激光多普勒血流仪、两点辨别法以及疼痛和温度感觉测试装置对50例修复病例（27例局部皮瓣、6例岛状皮瓣、7例游离皮片移植和10例微血管移植）进行检查。术后平均间隔时间为62个月。在皮瓣表面、供区以及与供区和原缺损相对应的对侧区域进行测量。采用配对t检验评估测量部位之间的统计学显著差异。
结果显示，局部皮瓣和岛状皮瓣表面的血流率和两点辨别率与未手术侧的相应区域相比无统计学差异。游离皮片移植后温度感觉恢复不完全，且与供区相比血流率增加。大型微血管皮瓣有6例出现皮肤感觉完全丧失，其余患者在平均39个月的间隔后发现感觉部分恢复，但两点辨别功能不可重现。微血管皮瓣的血流率与供区相当，且显著低于头颈部受区的血流率。
