Borah G L, Hidalgo D A, Wey P D
Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08901-0019, USA.
Ann Plast Surg. 1995 Mar;34(3):281-5; discussion 285-7. doi: 10.1097/00000637-199503000-00010.
This review represents the largest reported series involving reconstruction of complex scalp and calvarial defects with rectus abdominis free flaps. Sixteen patients presented with extensive (up to 300 cm2) scalp and calvarial defects requiring free tissue transfer for closure. All of the 11 patients who underwent a rectus abdominis free flap had a technically successful microvascular transfer. The defects encountered involved a wide spectrum of complexities including extensive multilaminar defects with exposed brain and dura, irradiated fields, and infection. In our institutions, the rectus abdominis muscle has evolved as a uniquely superior donor choice for restoring extensive scalp defects for several reasons: (1) accessibility, which eliminates intraoperative patient repositioning and allows for a simultaneous two-team approach; (2) minimal donor-site morbidity; (3) vascular reliability; and (4) the ability to supply abundant, easily contoured tissue.
本综述是报道的涉及使用腹直肌游离皮瓣修复复杂头皮和颅骨缺损的最大系列研究。16例患者出现大面积（达300平方厘米）头皮和颅骨缺损，需要进行游离组织移植来闭合创口。接受腹直肌游离皮瓣手术的11例患者中，所有微血管移植在技术上均获成功。所遇到的缺损涵盖多种复杂情况，包括伴有脑和硬脑膜外露的广泛多层缺损、放疗区域以及感染。在我们机构，腹直肌已成为修复大面积头皮缺损的独特且极为优越的供体选择，原因如下：（1）易于获取，无需术中重新摆放患者体位，且可采用同步双组手术方式；（2）供区并发症极少；（3）血管可靠性高；（4）能够提供丰富且易于塑形的组织。
