股前外侧穿支嵌合皮瓣修复口腔颌面肿瘤术后缺损

Perforator-based chimeric anterolateral thigh flap for oral and maxillofacial reconstruction after en bloc resection of cancer

目的探讨游离股前外侧穿支嵌合皮瓣修复口腔颌面部肿瘤术后软组织复杂缺损的效果。方法选择2011年1月至2014年7月以游离股前外侧穿支皮瓣修复口腔颌面部肿瘤术后缺损患者39例。术前以彩色多普勒探测并标记供区血管,结合术中探查设计并制备嵌合皮瓣,并以此嵌合皮瓣修复口腔颌面部软组织缺损,术后观察口腔颌面部及供区形态和功能。结果 39例游离股前外侧穿支嵌合皮瓣全部成活,其中3例术后24 h内出现血管危象,经处理后皮瓣逐渐恢复正常。随访1~4年,口腔颌面部及供区形态及功能良好,6例患者术后3年内复发、死亡,其余患者均无复发。结论游离股前外侧穿支嵌合皮瓣修复口腔颌面肿瘤术后软组织复杂缺损效果良好,值得临床推广应用。

Objective This study was aimed to observe the effects of the application of free perforator-based chimeric anterolateral thigh flap on patients with composite soft tissue defects after en bloc resection of cancer. Methods Thirty-nine patients with composite soft tissue defects after en bloc resection of cancer underwent simultaneous reconstruction with free perforator-based chimeric anterolateral thigh flap from January,2011 to July,2014 were observed. These perforator-based chimeric anterolateral thigh flaps were designed and harvested based on the marks on skin through preoperative Doppler probing and intraoperative exploration. The appearance and function of both the oral and maxillofacial region and the donor site were observed. Results All the 39 flaps survived. Vascular crisis occurred in three of them 24 h after surgery,but they gradually recovered with treatment. One to four years＇ follow-up showed satisfying morphology and function of both the accepting-sites and the donor sites. Six patients died of recurrence within 3 years after surgery.Conclusion Good effects can be reached using perforator-based chimeric anterolateral thigh flap for reconstruction of the composite soft tissue defects after en bloc resection of cancer in oral and maxillofacial region,which is worthy of application in clinical practice.