前臂皮瓣即刻整复口腔癌术后缺损方法的改进

目的 探讨前臂皮瓣即刻整复口腔癌术后缺损方法的改进。方法 收集本院1989年8月～2000年8月间用前臂游离皮瓣即刻整复口腔癌术后软组织缺损的患者47例。对该手术方法的改进进行分析和总结。结果 手术成功率100％。应用前臂桡侧皮瓣30例,尺侧（肌）皮瓣17例;吻合动静脉比例为1∶2.55。结论 口内缺损采用前臂真皮瓣修复;血管吻合尽量采用套接法;可只吻合皮瓣浅静脉;尽量保持颈外静脉主干完整性,采用侧支吻合;尽量缩短皮瓣缺血时间;尽量减少皮瓣及血管损伤;血管危象应尽早发现处理。

IMPROVEMENT OF METHODS FOR ONE-STAGE RECONSTRUCTION OF POSTOPERATIVE ORAL CANCER SOFT TISSUE DEFECTS WITH FOREARM FLAPS

ve To study the improvement of methods of one-stage repairing postoperative oral cancer soft tissue defects with forearm flaps. Methods 47 patients of oral and maxillofacial large composite defects repaired by the forearm free flaps are collected at the Department of Stomatology, Southwest Hospital, the Third Military Medical University from August 1989 to August 2000. The improved methods of the operations are analysed and reported. Results The success rate of operations was 100% . 30 radialis forearm flaps and 17 ulnaris forearm flaps were applied. The proportion of anastomosis of arteries to veins was 1:2.55. Conclusion Repairing intraoral defect with the forearm diepithelialized tissue flap (DTF). Microvascular anastomosis is by joining. Only anastomosing the superficial veins of the flaps is feasible. Anastomosing side veins to retain the whole external jugular vein. Reducing injuries of blood vessels. Shortenning the time of flap without blood. Finding and handling the blood vessel crisis earlier.