胸大肌肌皮瓣坏死感染原因分析

Risk factors for necrosis and infection of pectoralis major myocutaneous flaps

目的回顾性分析胸大肌肌皮瓣坏死原因,为临床提供指导。方法回顾性分析68例口腔癌同期行胸大肌肌皮瓣转移修复术的病例,对其皮瓣坏死的原因进行多元化分析。结果 68例病例中,12例出现坏死,其中3例完全坏死,9例部分坏死。结论肌皮瓣坏死是由于患者全身情况、皮瓣制取方法、供受区情况及术中、术后处理措施等多因素的影响,应对的关键在于保护肌皮瓣的血运,充分的术中止血、术后引流及良好的口腔护理。

OBJECTIVE To provide clinical guidance for the treatment of pectoralis major myocutaneous flap necrosis.METHODS 68 cases of oral carcinoma patients who also received pectoralis major myocutaneous flap transfer were retrospectively analyzed,and the risk factors of flap necrosis were diversity analyzed.RESULTS In 68 cases,necrotic complications occured in 12 cases,including 3 cases of complete necrosis and 9 cases of partial necrosis.CONCLUSION General condition of the patients,method of preparing PMMF,status of donor,recipient areas,and the management during and after operation were associated with the necrosis of PMMF.Proper preservation of blood supply for the flap,complete haemostasis during operation,good drainage,and adequate postoperative nursing are very important in preventing flap necrosis.