血管化前臂真皮脂肪瓣的制备及其供区的修复

Preparation of vascularized forearm dermal fat flap and repairing of donor site

目的:本研究制备血管化真皮脂肪瓣,采用原位皮肤的半厚皮片来关闭前臂供区,评估供区术后的美学及功能。方法:2020年7月-2023年6月行血管化前臂真皮脂肪瓣修复13例口腔颌面部软组织缺损,其中男8例,女5例;年龄42~71岁。切取皮瓣面积最大8cm×7cm,面积最小7cm×5cm,供区缺损采用原位皮肤的半厚皮片关闭。术后6个月,对前臂供区的颜色匹配程度、术区瘢痕、手腕活动和手部的感觉进行评估。结果:术后15例完全存活,所有患者术后供区均Ⅰ期愈合。术后随访6个月,前臂供区颜色匹配,无运动感觉功能障碍。结论:血管化前臂真皮脂肪瓣供区可以直接关闭,降低供区延期愈合的发生率,可以作为传统前臂皮瓣的替代方案,是口腔颌面部软组织缺损一种比较可靠的修复方式。

Objective This study prepared vascularized dermal fat flaps and introduced a local split-thickness skin graft from an in situ cutaneous area cutaneous area to manage forearm flap donor sites and evaluated the esthetic and functional outcomes post-operatively.From July 2020 to June 2023,13 patients with soft tissue defects in Oral and Maxillary Area were repaired with tvascular forearm dermal fat flap.There were 8 males and 5 females,aged from 42-71 years.The flaps ranged from 8 cm×7 cm to 7 cm×5 cm in size.The donor site defects were covered by local split-thickness skin graft from the in situ skins.The color matching degree,surgical scars,ranges of wrist movement and hand sensations in donor forearms were assessed at 6 months after surgery.Results The tvascular forearm dermal fat flaps for 15 cases all survived.All the local split-thickness skin grafts transplanted with this technique showed primary healing.The follow-up period for 6 months,Donor site exhibited suitabler color matching and there was not severe complications.Conclusion The vascularized dermal fat flap provides an alternative to conventional forearm flap harvest,which enables primary donor site closure with reduced rates of delayed donor site healing.The vascularized dermal fat flap is a relatively reliable repair method for soft defects in Oral and Maxillary Area.