游离股前外侧皮瓣修复口腔颌面部术后缺损

Reconstruction of oral and maxillofacial defect using free anterolateral thigh flaps after resection

目的探讨游离股前外侧皮瓣(ALTF)在口腔颌面部肿瘤术后缺损修复中的应用效果。方法采用ALTF游离移植修复23例口腔颌面部肿瘤根治术后的缺损,观察移植后ALTF成活、供区愈合情况,评价患者对手术的满意程度,受区的功能恢复情况。结果 22例移植皮瓣成活率为95.7%,其中4例术后12～36h出现静脉血管危象,3例抢救成功,皮瓣完全成活,另1例术后因皮瓣淤血时间较长,皮瓣部分坏死。病例随访3个月至2年,成活的皮瓣术后效果满意,受区功能恢复良好,供区无明显后遗症。结论游离ALTF具有供区组织量丰富,易成形,血管位置恒定且血管蒂长,皮瓣薄厚可根据缺损需要调整构成,供区较隐蔽,对供区功能及外形影响小等优点,是修复口腔颌面部组织缺损的良好材料。

Objective To explore the value of free anterolateral thigh flaps in the reconstruction of oral and maxillofacial defects following cancer radical resection. Methods 23 cases of oral and maxillofacial cancer underwent radical resection. Free anterolateral thigh flaps were used to reconstruct the defects. The survival situation of anterolateral thigh flaps, healing condition, function restoration and satisfaction of patients were all observed. Results Among 23 cases, 22 flaps survived completely with satisfied configuration, the survival rate was 95.7%. Postoperative vessel thrombosis occurred in 4 flaps between 12 hours to 36 hours after operation. 3 flaps were saved, 1 flaps fraction necrosis. 23 cases follow-up of 3 months to 2 years, no complications were observed in the donor site. Conclusions The free anterolateral thigh flap is an ideal choice for reconstruction of oral and maxillofacial defects, as it has many advantages such as abundance volume, easily molding and adjusting the thickness, possessing long vascular pedicle, composition need to be adjusted according to defects, easily concealed donor site, and little donor site complications and malformation.