Schmelzeisen R, Hausamen J E, Neukam F W, Schliephake H
Klinik und Poliklinik für Mund-, Keifer- und Gesichtschirurgie Mediznische Hochschule Hannover.
Fortschr Kiefer Gesichtschir. 1994;39:67-70.
Between 1989 and April 1993 29 grafts from the scapula region have been harvested for reconstruction in the head and neck area. 7 out of 20 osteocutaneous grafts have been used for reconstructions in the maxillary/midface area. In this area, one graft was completely lost due to venous congestion and another loss of the soft tissue component of one graft occurred. The complication rate in the maxilla seems to be higher than in application of the flap for mandibular reconstruction. Reconstruction in the maxillary/midface area most often requires several surgical steps. In special situations, as for example when unfavorable conditions regarding the recipient vessels exist, primary soft tissue reconstruction with a technically less demanding flap and a longer vascular pedicle (for example m. latissimus dorsi) and secondary free bone grafting may be indicated.
1989年至1993年4月期间，共采集了29块肩胛区移植物用于头颈部重建。20块骨皮瓣中有7块用于上颌骨/中面部重建。在该区域，1块移植物因静脉淤血完全失败，另1块移植物的软组织部分坏死。上颌骨重建的并发症发生率似乎高于下颌骨重建中皮瓣的应用。上颌骨/中面部重建通常需要多个手术步骤。在特殊情况下，例如当受区血管条件不佳时，可考虑先用技术要求较低、血管蒂较长的皮瓣（如背阔肌肌皮瓣）进行一期软组织重建，二期再行游离骨移植。
