前臂皮瓣串联髂骨肌瓣一期重建面下1/3大型复合缺损

SEQUENTIAL CONNECTION OF FLAPS:A NEW METHOD OF ONE STAGE CONSTRUCTION OF THE LARGE COMPOSITE DEFECT OF MANDIBLE

目的：行面下１／３复合组织缺损的一期重建，改善患者术后面部外形及口腔功能，提高患者的生存质量。方法：使用游离桡侧前臂皮瓣串联髂骨肌瓣。前臂皮瓣重建口腔粘膜、面部皮肤及部分舌体，髂骨肌瓣重建下颌骨缺损。结果：４例患者９块游离组织瓣全部存活，术后随访３～１２月，外形及功能满意。结论：前臂皮瓣串联髂骨肌瓣是一期重建面下１／３大型复合缺损较理想的方法，能较好的改善患者术后的面部外形及口腔功能，尤其适用于头颈部多次手术及放疗后的患者病例。

Objective:To report the clinical application of combination of the radial forearm flap with iliac crest free flap in one stage repair of the large composite defects of mandible in “chain flap”.Methods:The radial forearm flap was used for construction of the intraoral lining and facial skin,iliac crest free flap for mandible repair,which blood supply was provided by radial forearm flap Results:“Chain flap”was applied clinically in four cases since 1995 and nine flaps survived during 3 months￣one year follow up The functional results is satisfactory and improvement of aesthetic aspects in all cases No complication was found in donor site Conclusions:“Chain flap” were ideal and applicable in one stage repair for the large composite defect of mandible,especially in case of multiple head and neck surgery as well as post radiotherapy