前臂桡侧游离皮瓣在口腔颌面外科的应用——附725例临床分析

RADIAL FOREARM FREE FLAP FOR ORAL AND MAXILLOFACIAL RECONSTRUCTION ——CLINICAL ANALYSIS OF 725 CASES

目的详细阐述前臂桡侧游离皮瓣的应用解剖、制作技术、在口腔颌面外科的应用及新近研究进展。方法对我科自１９７９年以来，７２５例应用前臂桡侧游离皮瓣修复口腔颌面部各类缺损的病例，进行了临床分析。结果前臂桡侧游离皮瓣质地优良、血供可靠已及切取方便，总成功率达９６．６％；主要缺点是牺牲前臂的一条主供血管—桡动脉，供区疤痕明显，影响美观。结论前臂桡侧游离皮瓣是口腔颌面外科应用最多皮瓣，也是修复口腔颌面部软组织缺损的首选皮瓣。

Objective: A retrospective evaluation was performed so as to show the details of flap anatomy, harvest and the clinical application of scapular free flaps. Methods: The medical records of 22 cases of scapular free flap for oral and maxillofacial reconstruction were summed up and analyzed. Results: The scapular free flap is based on the subscapular vessel system. It can be designed as skin flap, osseous flap or compound flap, and the overall success rate is 100%. The main disadvantage is the need to reposition the paitent intraopratively to allow access to the scapular region, but if an extirpative procedure precede the scapular flap, repositioning the paitent for flap harvest and then again for flap insetting is diffcult and time consuming. Conclusion: The use of scapular free flap is decreased gradually with the popularization of radial forearm free flap and fibular free flap.