口腔颌面部缺损游离皮瓣修复中血管吻合的技巧及关键点

Vessel anastomosis in free flap reconstruction for oral and maxillofacial defects:techniques and key points

血管吻合的质量是决定游离皮瓣移植修复术是否成功最为关键的因素。游离皮瓣在修复口腔颌面部缺损的应用中存在血管选择、受区血管相关术中表现和血管吻合技术等方面的诸多特点及技巧。同时,术后对皮瓣危象、并发症进行判断和处理时也有较多的关键点。笔者的团队在近年来开展了大量的口腔颌面缺损游离皮瓣修复,在口腔颌面颈部的血管吻合方面积累了大量的经验。本文针对口腔颌面缺损游离皮瓣修复中动静脉吻合的技巧、血管选择、血管危象的判断及处理等问题进行评述。

The quality of vessel anastomosis is a key element for the success of free flap reconstruction.When adopting free flaps for oral and maxillofacial defect reconstruction,skills in selecting vessels,determining the clinical manifestations of the recipient vessel,and anastomosis technique are needed.Key points on postoperative flap observation were also required.We are experienced on this subject given that we have accomplished more than 1000 free flaps for patients with oral and maxillofacial defects in the last 5 years.In this article,we summarize the skills and key points in free flap reconstruction of oral and maxillofacial defects,including vessel anastomosis skills,vessel selection,and vessel crisis diagnosis.