Blackwell K E, Buchbinder D, Biller H F, Urken M L
Division of Head and Neck Surgery, University of California Los Angeles School of Medicine, 90095-1624, USA.
Head Neck. 1997 Oct;19(7):620-8. doi: 10.1002/(sici)1097-0347(199710)19:7<620::aid-hed10>3.0.co;2-6.
Massive defects resulting from excision of advanced head and neck tumors may not be amenable to reconstruction using a single technique of tissue transfer. Sixteen patients undergoing reconstruction using simultaneous free flaps and pedicled regional flaps are presented.
Regional flaps included the pectoralis major, deltopectoral, cervical visor, paramedian forehead, cervicofacial, and nape of neck flaps. Microvascular tissue transfers included the radial forearm, iliac crest, parascapular/latissimus dorsi, rectus abdominis, fibula, and lateral thigh free flaps.
Most defects involved both aerodigestive mucosa and external cutaneous skin. Mucosal reconstruction was carried out using the soft-tissue component of the free flaps, whereas vascularized bone was used for mandibular reconstruction. Regional flaps were used to reconstruct skin of the face and neck.
When planned and applied in a stepwise fashion, simultaneous free flaps and regional flaps are complimentary for the reconstruction of complex wounds in the head and neck.
晚期头颈肿瘤切除后产生的大面积缺损可能无法采用单一组织转移技术进行修复。本文介绍了16例采用游离皮瓣和带蒂区域皮瓣联合修复的患者。
区域皮瓣包括胸大肌皮瓣、三角肌胸大肌皮瓣、颈部遮阳皮瓣、前额正中皮瓣、颈面部皮瓣和颈后皮瓣。微血管组织转移包括桡侧前臂游离皮瓣、髂嵴游离皮瓣、肩胛旁/背阔肌游离皮瓣、腹直肌游离皮瓣、腓骨游离皮瓣和股外侧游离皮瓣。
大多数缺损同时累及气道消化道黏膜和体表皮肤。游离皮瓣的软组织部分用于黏膜重建，而带血管蒂的骨组织用于下颌骨重建。区域皮瓣用于重建面部和颈部皮肤。
当按步骤进行规划和应用时，游离皮瓣和区域皮瓣联合使用对头颈复杂伤口的修复具有互补作用。
