前臂游离皮瓣一期整复口腔内软组织缺损36例分析

Forearm free skin flap for 36 cases of one-stage reduction of oral soft tissue defects

目的:分析36例前臂游离皮瓣一期整复口腔内软组织缺损手术相关情况,旨在为前臂游离皮瓣整复手术的临床应用提供高价值实践经验。方法:选取2011年1月至2016年1月行前臂游离皮瓣一期整复口腔内软组织缺损的36例患者的临床(随访)资料进行回顾性分析,统计患者手术相关情况,包括术后成活皮瓣数、皮瓣恢复情况等,并对失败病例进行分析。结果:本研究共行36例前臂游离皮瓣整复手术,其中24例皮瓣选自前臂尺侧,12例皮瓣选自前臂桡侧,平均皮瓣大小为(47.98±7.52)cm^2,平均动脉血管蒂长为(5.87±3.69)cm,平均静脉血管蒂长为(7.98±3.82)cm,手术成功率为94.44%,且供区功能恢复良好。结论:临床在开展口腔内软组织缺损整复手术时,积极防治血管危象、完善术前准备、术中操作及术后监控能获得更佳的手术效果。

Objective:To analyze the related conditions of forearm free skin flap for 36 cases of one-stage reduction of oral soft tissue defects and provide bases for reconstructive surgery.Methods:The clinical or follow-up data of 36 patients with oral soft tissue defects treated by one-stage reduction from January 2011 to January 2016 were retrospectively analyzed.The related conditions of surgery,such as the number of survived skin flaps after surgery and flap recovery were statistically analyzed,and failure cases were analyzed.Results:In the study,24 cases of skin flaps were collected from the ulnar side of the forearm and 12 cases of skin flaps were collected from the radial side of the forearm.The average size of skin flaps,the mean length of arterial vascular pedicle and the mean length of venous vascular pedicle were(47.98±7.52)cm 2,(5.87±3.69)cm and(7.98±3.82)cm,respectively.The success rate of surgery was 94.44%,and the functional recovery of donor site was good.Conclusion:In the reduction of oral soft tissue defects,better surgical results can be achieved when vascular crisis is prevented and treated actively,and preparations before surgery,operation during surgery and monitoring after surgery are improved.