股前内侧皮瓣作为替代皮瓣在颌面部软组织缺损中的应用

Application of anteromedial thigh flap as a alternative flap in maxillofacial soft tissue defects

目的:探讨股前内侧皮瓣作为替代皮瓣在颌面部软组织缺损修复中的应用价值。方法:60例拟行股前外侧皮瓣修复手术的患者,术前常规行CT血管造影,利用影像工作站,分别于股前内侧、外侧区定位穿支血管的体表位置。其中有4例在股前外侧皮瓣制备过程中无合适穿支,在同一术区依据股前内侧区定位的穿支血管的体表位置,再次制备股前内侧皮瓣修复缺损。结果:4例股前内侧皮瓣均完全成活,切取皮瓣面积最大9 cm×6 cm,最小7 cm×4 cm,随访6~12个月,受区及供区功能恢复满意。结论:术前应用CT血管造影能够有效地提高皮瓣制备的准确性,制备股前外侧皮瓣无合适穿支血管时,使用同侧股前内侧皮瓣是一种有效的替代方案。

Objective:To explore the application value of anteromedial thigh flap(AMT)as alternative flap in repairing maxillofacial soft tissue defects.Method:Sixty patients were scheduled to underwent anterolateral thigh flap(ALT)reconstruction.Preoperative CT angiography were conducted.Imaging workstations were used to locate perforator vessels in the anterolateral and anteromedial areas respectively.Four patients had no suitable perforator during the preparation of AMT flaps.In the same operation area,ALT flaps were prepared to reconstruct the defect according to the location of the perforator vessels in the anteromedial areas.Result:All four AMT flaps survived uneventfully.Flap sizes ranged from 9 cm×6 cm to 7 cm×4 cm.The follow-up period ranged from 6 to 12 months,the functions of recipient and donor sites recovered well.Conclusion:Preoperative CT angiography can improve the accuracy of the preparation of skin flap effectively.When no sizable perforator is available during harvest of the ALT flap,successful reconstruction can be achieved using the ipsilateral AMT flap.