摘要
目的为解决由各种原因引起的面颌部洞穿性缺损的修复问题。方法采用两个带蒂的组织瓣搭配使用修复面颌部洞穿缺损45例,共用组织瓣90个。其中胸三角皮瓣58个(占64%),依次是颈阔肌肌皮瓣,胸大肌肌皮瓣,额部皮瓣,胸锁乳突肌肌皮瓣,背阔肌肌皮瓣等。结果45例洞穿性缺损所用90个组织瓣中全部成活及绝大部分成活者87个,成活率达97%,全部或大部分坏死的3个(占3%)。结论面颌部洞穿性缺损即刻修复是可行的。修复洞穿缺损有多种皮瓣、肌皮瓣可供选择;提出胸三角皮瓣、颈阔肌肌皮瓣、胸大肌肌皮瓣等是修复面颌部洞穿性缺损的优质组织瓣。临床应用中取得了功能与外形同时修复的效果。
Objective To solve the problems in restoration of perforating(full thickness)defects in the maxillofacial region.Methods Double flaps have been used to reconstruct the defects.Forty-five pa- tients with full thickness defects on the maxillofacial region were treated with 90 flaps,including 58 (64%)deltopectoral flaps,the platysma myocutaneous flap,pectoralis major myocutaneous flap,ster- nomastoid myocutaneous flap,forehead flap and latissimus myocutaneous flap.Results The operation re- sults were satisfactory.Of the 90 flaps,87 flaps survived completely or subtotally with a successful rate of 97%.Three flaps sustained total or large necrosis.Conclusion A number of flaps can be used for repairing the full thickness defects of the maxillofacial region,especially the deltopectoral flap,the platysma myocu- taneous flap and the pectoralis major myocutaneous flap.They can provide excellent external cover or inter- nal lining.They are well vascularized,hairless and colour-matched.
