前臂真皮脂肪瓣在口腔颌面部软组织缺损中的临床研究

Clinical Comparative Research of Forearm Dermal Fat Flap for Reconstruction of Defects in Oral and Maxillofacial Region

目的:评估前臂真皮脂肪瓣在口腔颌面部软组织缺损修复中的应用效果。方法:2020年7月~2023年6月,行前臂皮瓣修复24例口腔颌面部软组织缺损。根据制取皮瓣的方法不同,分为传统前臂皮瓣组(n=12)和前臂真皮脂肪瓣组(n=12),对皮瓣制取时间、皮瓣大小、术后6月前臂供区的外观及功能进行评估。结果:两组皮瓣存活率均为100%。传统前臂皮瓣组较真皮脂肪瓣组皮瓣制取时间明显缩短(P<0.05),两组皮瓣大小差异无统计学意义(P>0.05)。术后6月,两组患者在供区色素沉着及供区瘢痕差异有统计学意义(P<0.05),在手部感觉及手腕活动方面差异无统计学意义(P>0.05)。结论:两组患者在供区功能恢复方面无差异,但前臂真皮脂肪瓣避免了第三术区,对供区外观影响小,可以作为传统前臂皮瓣的替代方案。

Objective:To evaluate the applicable effect of forearm dermal fat flap in the repair of defects in oral and maxillofacial region.Methods:From July 2020 to June 2023,24 patients with soft tissue defects in oral and maxillofacial region were repaired with forearm flap.According to the method of operation criteria,24 patients were divided into traditional forearm flap group(12 cases)and forearm dermal fat flap group(12 cases).The flap preparation time,flap size,and the appearance and function of the forearm donor site at 6 months post-operatively were evaluated.Results:The flap survival rates of both groups were 100%.The flap preparation time of traditional forearm flap group was shorter than that of the forearm dermal fat flap group(P<0.05),and there was no difference in the flap size between two groups(P>0.05).Six months after the surgery,there was significant difference in the pigment deposition and surgical scars in the donor area between two groups(P<0.05),however,no significant difference in hand sensation and wrist movement(P>0.05).Conclusion:There was no difference in the functional recovery of the donor site between two groups of patients.The forearm dermal fat flap avoided the third surgical site and had little impact on the appearance of the donor site,which provided an alternative to the conventional forearm flap harvest.