Hallock G G
Division of Plastic Surgery, Allentown Hospital, Pa.
Plast Reconstr Surg. 1993 Jul;92(1):70-6. doi: 10.1097/00006534-199307000-00010.
Accusations of excessive donor-site morbidity as an unavoidable sequela of fasciocutaneous flaps has negatively prejudiced this option for coverage of adjacent defects such that a muscle flap, if available, would instead be preferable even at the risk of loss of marginally expendable function. Our entire experience with 147 juxtaposed muscle-type and 122 fascia-type flaps was analyzed to confirm instead that actual donor-site morbidity was extremely uncommon for either type. Overall, there were 20 (14 percent) complications of the donor site of muscle flaps and 17 (14 percent) for fascial flaps, with only 4 (3 percent) major complications in each group. This almost minuscule incidence of major morbidity was about five times less than the rate of major complications involving the flaps themselves (14 percent for muscle and 15 percent for fascial flaps). Unless aesthetic considerations are of paramount importance, at least from a functional standpoint, no difference in donor-site complications could be discerned between these two disparate flap types. However, the skin-grafted donor site of the fasciocutaneous flap results in a significant cosmetic disadvantage similar to that of a large musculocutaneous flap.
对于筋膜皮瓣而言，供区并发症过多被指责为不可避免的后遗症，这对其用于修复相邻缺损的选择产生了负面影响，以至于如果有肌肉瓣可用，即使存在牺牲边缘可消耗功能的风险，使用肌肉瓣也会更可取。我们分析了147例并列的肌肉型皮瓣和122例筋膜型皮瓣的全部经验，结果却证实，实际上这两种类型皮瓣的供区并发症都极为罕见。总体而言，肌肉瓣供区有20例（14%）并发症，筋膜瓣供区有17例（14%）并发症，每组仅有4例（3%）严重并发症。这种几乎极小的严重并发症发生率比皮瓣本身的严重并发症发生率低约五倍（肌肉瓣为14%，筋膜瓣为15%）。至少从功能角度来看，除非美学因素至关重要，否则这两种截然不同的皮瓣类型在供区并发症方面并无差异。然而，筋膜皮瓣的植皮供区会导致明显的美容缺陷，类似于大型肌皮瓣。
