Hasegawa K, Amagasa T, Araida T, Miyamoto H, Morita K
Department of Oral and Maxillofacial Surgery, Shizuoka City Hospital, Japan.
J Craniomaxillofac Surg. 1994 Aug;22(4):236-43. doi: 10.1016/s1010-5182(05)80564-5.
The rectus abdominis myocutaneous flap consists of the skin paddle, anterior rectus sheath, rectus muscle and deep inferior epigastric artery and veins. Of these four components, the skin paddle, rectus sheath and rectus muscle could all be adjusted appropriately for reconstruction sites. Only one or two large perforators in the paraumbilical region could easily supply the large abdominal wall. The bulkiness of the rectus abdominis flap is reduced by removal of subcutaneous fat and rectus muscle. These possibilities can provide many modification of the flap for various reconstruction sites. 16 cases were reconstructed primarily and secondarily using this flap after oral and maxillofacial tumour ablation. The results of these cases indicated a very favourable and reliable vascularity. The rectus abdominis myocutaneous flap was considered to be one of the most suitable flaps for oral and maxillofacial reconstruction. Various modifications for different reconstruction sites are mainly discussed.
腹直肌肌皮瓣由皮瓣、腹直肌前鞘、腹直肌以及腹壁下深动静脉组成。在这四个组成部分中，皮瓣、腹直肌鞘和腹直肌都可以根据重建部位进行适当调整。脐旁区域通常只有一两个大的穿支血管，就能轻松为大面积的腹壁供血。通过去除皮下脂肪和腹直肌，可以减少腹直肌瓣的臃肿程度。这些优势使得该皮瓣能够针对不同的重建部位进行多种改良。16例口腔颌面肿瘤切除术后患者接受了该皮瓣的一期和二期重建。这些病例的结果显示皮瓣血供非常良好且可靠。腹直肌肌皮瓣被认为是口腔颌面重建中最合适的皮瓣之一。本文主要讨论针对不同重建部位的各种改良方法。
