游离股前外侧皮瓣修复面颊部大面积洞穿性缺损

Reconstruction of extensive full thickness cheek defects with free anterolateral thigh flap

目的 评估游离股前外侧皮瓣修复重建面颊部大面积洞穿性缺损的临床特点和治疗效果. 方法 2008年12月-2014年6月,对17例颌面部恶性肿瘤根治性切除的患者应用游离股前外侧皮瓣修复面颊部大面积洞穿性缺损.其中12例采取了折叠股前外侧皮瓣（去除中间区域的真皮层）重建面颊部皮肤及口腔黏膜;5例采取了一蒂双岛的分叶股前外侧皮瓣修复面颊部洞穿性缺损（一个皮岛修复面颊部皮肤,另一个皮岛修复口腔黏膜）.结果 17例股前外侧皮瓣均成活,仅1例糖尿病患者因伤口感染导致皮瓣边缘的部分损失.经术后3- 12个月随访,折叠股前外侧皮瓣和分叶股前外侧皮瓣外形、质地均良好,患者口腔颌面部形态、功能得以重建. 结论 游离股前外侧皮瓣应用灵活,通过其折叠或分叶的方式修复面颊部大面积洞穿性缺损取得良好的效果.

Objective To assess the clinical features and therapeutic efficacy of extensive full thickness cheek defects reconstruction with free anterolateral thigh flap.Methods From December,2008 to June,2014,a total of 17 patients underwent simultaneous tumor radical resection and full thickness cheek defects reconstruction with free anterolateral thigh flap.In these 17 patients,12 patients had undergone the reconstruction of full thickness cheek defects with the folded anterolateral thigh flap （two skin islands and an intervening de-epithelialized zone）; 5 patients had undergone the reconstruction of full thickness cheek defects with the two separate skin paddles anterolateral thigh flap in one single pedicle.Results All of 17 free anterolateral thigh flaps survived,besides 1 case resulted in partial loss of flap adge due to diabetes.After 3 to 12 months＇ follow-up,all cases of free anterolateral thigh flap were good in color,shape and texture,and patients were satisfied with oral morphological and functional reconstruction.Conclusion The free anterolateral thigh flap is one of versatile soft tissue flaps in the extensive full thickness cheek defects reconstruction.