Schusterman M A, Miller M J, Reece G P, Kroll S S, Marchi M, Goepfert H
Department of Reconstructive and Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
Plast Reconstr Surg. 1994 Mar;93(3):472-8; discussion 479-80.
Since its inception at our institution in 1988, microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 308 free flaps performed over the last 4 years was done to evaluate the complication and flap loss rates and to investigate which factors may contribute to these rates. The overall complication rate was 36.1 percent, the vessel thrombosis rate was 6.8 percent, the flap loss rate was 5.5 percent, and the flap salvage rate was 19.0 percent. Multifactorial analysis of delayed reconstruction, tobacco use, alcohol consumption, previous radiation therapy, previous surgery, and use of vein grafts showed that only previous surgery and the use of vein grafts led to significantly higher rates of flap loss (p < 0.01 for both).
自1988年在我们机构开展以来，微血管重建手术已成为头颈癌患者治疗中不可或缺的一部分。本次对过去4年中实施的308例游离皮瓣手术进行回顾，旨在评估并发症和皮瓣丢失率，并探究哪些因素可能导致这些发生率。总体并发症发生率为36.1%，血管血栓形成率为6.8%，皮瓣丢失率为5.5%，皮瓣挽救率为19.0%。对延迟重建、吸烟、饮酒、既往放疗、既往手术以及静脉移植使用情况进行多因素分析表明，只有既往手术和静脉移植的使用导致皮瓣丢失率显著更高（两者p均<0.01）。
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