Wolff K D, Ervens J, Hoffmeister B
Department of Maxillofacial Plastic Surgery at the Benjamin Franklin Medical Center, Berlin, Germany.
Plast Reconstr Surg. 1996 Aug;98(2):358-62. doi: 10.1097/00006534-199608000-00025.
A basic disadvantage of radial forearm flaps is the removal of skin from a functionally important and cosmetically exposed region. To minimize the donor-site morbidity of the radial forearm flap, we have thus far used a two-phase procedure for intraoral defect coverage in five patients: In a first step, a split-thickness skin graft is transplanted to the forearm fascia, which "takes" there over a period of 2 weeks. In step two, the prefabricated fascial-split-thickness skin flap can be raised with complete preservation of the forearm skin and microsurgically transplanted like a conventional radial flap. Performing this procedure, we have obtained the following results: (1) All skin grafts "took" completely on the forearm fascia. (2) Prefabricated fascial-split-thickness skin flaps could be raised without any problems, like conventional radial forearm flaps. (3) All flaps were excellently suited for defect coverage in the oral cavity as very thin and moldable grafts and "took" without any complications. (4) Tension-free primary closure of all forearm donor sites was achieved with only slight cosmetic and functional impairment.
桡侧前臂皮瓣的一个基本缺点是要从功能重要且在外观上暴露的区域取皮。为了将桡侧前臂皮瓣供区的发病率降至最低，我们目前已对5例患者采用两阶段手术来覆盖口腔内缺损：第一步，将中厚皮片移植到前臂筋膜上，该皮片在2周时间内在此处“成活”。第二步，预制的筋膜中厚皮瓣可以在完全保留前臂皮肤的情况下掀起，并像传统桡侧皮瓣一样进行显微外科移植。实施该手术，我们取得了以下结果：（1）所有皮片均在前臂筋膜上完全“成活”。（2）预制的筋膜中厚皮瓣能够像传统桡侧前臂皮瓣一样毫无问题地掀起。（3）所有皮瓣作为非常薄且可塑形的移植物非常适合覆盖口腔内缺损，且“成活”无任何并发症。（4）所有前臂供区均实现了无张力一期缝合，仅伴有轻微的外观和功能损害。
