胸大肌肌皮瓣脂肪液化的相关危险因素探讨

Risk factors of fat necrosis in pectoralis major myocutaneous flaps

目的探讨胸大肌肌皮瓣术后发生脂肪液化的相关危险因素。方法对1998年5月至2005年12月采用胸大肌肌皮瓣修复口腔癌术后组织缺损的82例中10例术后发生不同程度脂肪液化的病例,进行Logistic回归分析。结果Logistic单因素回归分析结果表明：肥胖、电刀切开皮下组织、皮岛设计低于第7肋、吸烟等因素与胸大肌肌皮瓣术后发生脂肪液化有关;Logistic多因素回归分析结果表明：胸大肌肌皮瓣术后发生脂肪液化与肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素有关,而与吸烟无关。结论肥胖、电刀切开皮下组织、皮岛设计低于第7肋等因素是胸大肌肌皮瓣术后发生脂肪液化的危险因素。

Objective To explore the risk factors of fat necrosis in pectoralis major myocutaneous flaps. Methods From May 1998 to December 2005, 82 patients underwent reconstruction of oral and maxiflofaeial defects with pectoralis major myocutaneous flaps in our hospital. Postoperative fat necrosis of the flaps was occurred in 10 cases. Logistic regression analysis was used to investigate the risk factors. Results ①Logistic univarlate regression analysis indicated that there was a significant correlation between fat necrosis of pectoralis major myocutaneous flap and the following risk facoars： obesity, subcutaneous tissues dissection performed by electrotome, the design of skin island beyond the seventh costal cartilage and smoking.② Logistic multivariate regression analysis suggested that there was a significant correlation between fat necrosis of pectoralis major myocutaneous flap and obesity, subcutaneous tissues dissection performed by electrotome, the design of skin island beyond the seventh costal cartilage, whereas there was no significant correlation between fat necrosis of flap and smoking. Conclusions Obesity, subcutaneous tissues dissection performed by electrotome and the design of skin island beyond the seventh costal cartilage were the risk factors of fat necrosis in pectoralis major myocutaneous flap.