Pribaz J J, Morris D J, Mulliken J B
Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Mass.
Plast Reconstr Surg. 1994 Feb;93(2):285-93. doi: 10.1097/00006534-199402000-00008.
Free-tissue transfer has emerged as the ideal way of reconstructing complex facial defects. Multifaceted free flaps are often needed, and we have developed a simple technique to determine both the volume of tissue required and the localization of the various epithelial surfaces, thereby simplifying these complex reconstructions. We report our experience in reconstructing 19 complex facial defects in which we have used an intraoperative alginate moulage that has provided an accurate three-dimensional model of the defect, helping to determine the volume of the flap required. The reconstruction was further simplified by converting this three-dimensional model into a two-dimensional pattern by wrapping the model with a piece of Esmarch bandage, thereby determining the locations and sizes of the epithelial surfaces. The pattern was then transferred to the donor site and the flap de-epithelialized and thinned in situ with complete confidence that the tissue was "tailor-made" for the defect.
游离组织移植已成为修复复杂面部缺损的理想方法。通常需要多平面游离皮瓣，我们开发了一种简单技术，既能确定所需组织的体积，又能确定各种上皮表面的位置，从而简化这些复杂的修复过程。我们报告了修复19例复杂面部缺损的经验，术中使用藻酸盐印模法提供了缺损的精确三维模型，有助于确定所需皮瓣的体积。将该三维模型用一块埃斯马赫绷带包裹转化为二维图案，进一步简化了修复过程，从而确定上皮表面的位置和大小。然后将该图案转移到供区，在原位对皮瓣进行去上皮化和变薄处理，完全确信该组织是为缺损“量身定制”的。
