摘要
目的:改良传统前臂皮瓣的设计方式,探索直接关闭前臂供区缺损的方法。方法:收集25例口腔颌面部恶性肿瘤及非肿瘤术后的颌面部缺损患者,设计前臂梭形皮瓣进行修复重建。对于颌面部中型缺损,将梭形皮瓣对折缝合,术后前臂供区直接拉拢缝合。结果:25例前臂梭形皮瓣,术后仅1例出现皮瓣坏死,其余全部成活。术后随访皮瓣外形适宜,恢复良好。前臂供区无需植皮,术后愈合良好,瘢痕小。患者对前臂供区美观度的主观评价调查问卷平均值8.56分,术后患者未出现手部运动或功能障碍。25例患者中,满意24例,不满意1例,满意度为96%。结论:应用前臂梭形皮瓣修复颌面部缺损,术后外形、功能恢复良好,皮瓣制备简单易行,安全可靠。术后可直接拉拢缝合前臂供区,无需植皮,创伤小,术后手部及腕关节运动功能正常;而且术后瘢痕小,患者满意度高,值得临床推广应用。
PURPOSE:To improve the traditional forearm flap and explore the clinical method of directly closing the donor area of the forearm.METHODS:Twenty-five cases of oral and maxillofacial malignant tumor or maxillofacial defects were collected and reconstructed with forearm fusiform flap.For maxillofacial medium defect,fusiform flap could be folded and sutured in half,and the donor site of the forearm could be closed directly after flap havesting.RESULTS:Among 25 cases of forearm fusiform flaps,only 1 case had flap necrosis after operation,and all the others survived.The donor area of the forearm did not require skin grafting,and the postoperative healing was normal and the scar was small.The average satisfaction score of the subjective questionnaire answered by patients was 8.56.No significant restriction of hand movement was observed after surgery in all cases.Of the 25 patients,24 patients were satisfied with the surgery and 1 patient was dissatisfied,with a satisfaction rate of 96%.CONCLUSIONS:The application of forearm fusiform flap has good appearance and function recovery,and the preparation of which is simple,safe and reliable.After surgery,the donor area of the forearm can be directly co-sutured and closed,without skin grafting,implying little trauma,normal movement and function of the hand and wrist after surgery,small postoperative scars,high patient satisfaction,and worthy of clinical application.
作者
李晓高
邓华
何倩婷
LI Xiao-gao;DENG Hua;HE Qian-ting(Department of Stomatology,the Third People's Hospital of Datong.Datong 037000,Shanxi Province;Surgery and Anesthesia Center,The First Affiliated Hospital of Sun Yat-sen University.Guangzhou 510000,Guangdong Province,China;Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Sun Yat-sen University.Guangzhou 510000,Guangdong Province,China)
出处
《中国口腔颌面外科杂志》
CAS
2024年第5期473-477,共5页
China Journal of Oral and Maxillofacial Surgery
关键词
前臂皮瓣
梭形皮瓣
供区关闭
皮瓣设计
Radial forearm free flap
Fusiform flap
Donor site closure
Flap design
