游离股后内侧穿支皮瓣与股前外侧穿支皮瓣在口腔颌面部缺损重建中的应用

Application of Free Posteromedial Femoral Perforator Flap and Anterolateral Femoral Perforator Flap in the Reconstruction of Oral and Maxillofacial Defects

目的:探讨游离股后内侧穿支皮瓣与股前外侧穿支皮瓣在口腔颌面部缺损重建中的应用效果。方法:选取2019年1月-2021年2月阳江市人民医院收治的40例口腔颌面部肿瘤手术患者。根据随机数字表法将其分为A组和B组,各20例。A组采用游离股后内侧穿支皮瓣对口腔颌面部缺损进行重建,B组采用游离股前外侧穿支皮瓣对口腔颌面部缺损进行重建。比较两组皮瓣制备时间,术后随访6个月,统计两组创面Ⅰ期愈合率、并发症发生率、皮瓣质量与供区隐蔽性的满意度、皮瓣感觉功能。结果:两组皮瓣制备时间、创面Ⅰ期愈合率、皮瓣质量优良率、皮瓣感觉功能优良率比较差异均无统计学意义(P>0.05)。两组术后创面感染、脂肪液化、血管危象、皮瓣坏死发生率比较差异均无统计学意义(P>0.05)。A组供区隐蔽性满意度评分高于B组(P<0.05)。结论:游离股后内侧穿支皮瓣与股前外侧穿支皮瓣均是修复口腔颌面部缺损的良好材料,皮瓣质量好,创面愈合及感觉功能恢复理想。但游离股后内侧穿支皮瓣供区隐蔽性高,临床可根据实际需要及患者自身条件灵活选择供区。

Objective:To explore the application effect of free posteromedial femoral perforator flap and anterolateral femoral perforator flap in the reconstruction of oral and maxillofacial defects.Method:A total of 40 patients who underwent oral and maxillofacial tumors surgery admitted to Yangjiang People’s Hospital from January 2019 to February 2021 were selected.According to the random number table method,they were divided into group A and group B,with 20 cases in each group.In group A,free posteromedial femoral perforator flap was used to reconstruct the oral and maxillofacial defects,and in group B,free anterolateral femoral perforator flap was used to reconstruct oral and maxillofacial defects.The flap preparation time in the two groups were compared,and the patients were followed up for 6 months after surgery,the wound healing rate of phaseⅠ,the incidence of complications,flap quality and satisfaction with the concealment of the donor area,and the sensory function of the flap were counted.Result:There were no significant differences in flap preparation time,the wound healing rate of phaseⅠ,excellent and good rate of flap quality and flap sensory function between the two groups(P>0.05).There were no significant differences in the incidences of wound infection,fat liquefaction,vascular crisis and flap necrosis between the two groups(P>0.05).The score of satisfaction with the concealment of the donor area in group A was higher than that in group B(P<0.05).Conclusion:Free posteromedial femoral perforator flap and anterolateral femoral perforator flap are good materials for repairing oral and maxillofacial defects.The quality of the flap is good,and the wound healing and sensory function recovery are ideal.But the concealment of the donor area in the free posteromedial femoral perforator flap is high,so the donor area can be flexibly selected according to the actual needs and patients’own conditions.