游离腹壁下深动脉穿支皮瓣修复头颈肿瘤术后缺损

Deep inferior epigastric artery perforator flaps in head and neck reconstruction

目的:探索供区功能损伤更小的腹壁下深动脉穿支(DIEAP)皮瓣,用于头颈部肿瘤术后缺损修复。方法:2004年1月～2006年12月,应用DIEAP皮瓣修复头颈部手术缺损患者共12例。手术缺损部位分别为全舌或近全舌缺损6例,面中部缺损3例,颊黏膜洞穿缺损2例,颅底合并头皮缺损1例。结果:11例DIEAP皮瓣修复成功(92%),1例因吻合侧的颈内静脉血栓形成导致皮瓣坏死。供区一期愈合,未发现腹壁疝和腹壁隆起等手术并发症。结论:游离DIEAP皮瓣保留了腹直肌和前鞘,将供区并发症降到最低限度,是头颈部缺损修复新的可靠技术。

PURPOSE： The advantage of perforator flaps versus musculocutaneous flaps is the reduced morbidity of the donor site with preservation of the nerves, muscles and deep fascia. We evaluate the reconstruction result of deep inferior epigastric artery perforator （DIEAP） flaps in head and neck region. METHODS： A retrospective review was performed on 12 deep inferior epigastric artery perforator （DIEAP） free flap reconstructions for head and neck tumor ablation defects between January of 2004 and December of 2006. The recipient sites were subdivide into defects of total or near total glossectomy （n=6）, three dimensional defect of midface （n=3）, buccal perforated defects （n=2）, and anterior skull base with an external skin component defect （n=1）. RESULTS： The overall free flap success rate was 92% （11/12）. One DIEAP flap lost because the draining jugular vein was thrombosed. No complications were observed in the donor site, including abdomen bulge or hernia. CONCLUSION： Due to the advantage of the minimum donor site morbidity, DIEAP flap is a new and reliable reconstruction choice for head and neck surgical defects.