带蒂皮瓣修复口底缺损失败原因分析

Unsuccess Cause Analysis of Pedunculated Flaps Reconstructed the Defect of Floor of the Mouth

目的 对 11例口底缺损后皮瓣修复坏死原因进行分析。方法 收集 5 6例带蒂肌皮瓣修复口底缺损 ,11例口底恶性肿瘤切除后即刻进行带蒂皮瓣修复 ,并进行比较分析。结果 比较 5种带蒂皮瓣修复法 ,其成功率的顺序是 :额瓣、胸大肌肌皮瓣、斜方肌肌皮瓣、胸锁乳突肌肌皮瓣、舌骨下肌群皮瓣。结论 皮瓣坏死有供区供血系统及口底区解剖结构上的原因 ,也有术者手术的主观原因 。

Objective To analyze the reason of necrosis for pedunculated skin flaps repaired after floor of the mouth defect repair.Methods 56 cases of pedunclated-flaps restoring the floor of the mouth from 1996 to 2001 were reviewed, and pedunclated-flap repair was performed after operation in 11 cases suffering from malignant tumors in the floor of the mouth, and 5 kinds of pedunculated flaps were compared.Results Five kinds of pedunculated flaps were used to reconstruct the floor of the mouth defects. Its successful sequence was as following: forehead flap, pectoralis major myocutaneous flap, sternocleidomastoid flaps,trapezius myocutaneous flaps, and subhyoid flap.Conclusions Causes of those flaps necrosis might relate to furnishing blood with supplied-flaps region and structure of anatomy in received-flaps region, also it is related to operater's skill.So the reason of repair failure of skin flaps with pedicle needs comprehensive analysis.