游离股动脉蒂穿支皮瓣在口颊癌术后缺损修复中的临床应用

目的 探讨游离股动脉穿支皮瓣的临床解剖及其在口颊癌术后缺损修复中的应用。方法 2015年12月—2019年6月选取接受了游离股动脉穿支皮瓣颊修复术男性口颊癌患者13例，年龄37~61岁，平均48.5岁。病理类型为鳞状细胞癌。据TNM分期其中T4N0M0 5例，T4N1M0 2例，T3N1M0 2例，T3N2M0 4例。病程3~16个月，平均9.8个月。游离股动脉穿支皮瓣的具体选择形式包括：①单纯穿支皮瓣7例；②穿支嵌合体肌皮瓣6例。结果 术中皮瓣大小规划范围在6.5 cm×4.0 cm～10.0 cm×6.5 cm，厚度为2.5～3.5 cm。股动脉穿支血管蒂长为（6.2±0.4） cm，供区聚拢闭合缝合。13例皮瓣均成活，供受区一期愈合。随访患者12～30个月，平均21.3个月。重建的口腔外观无肿胀偏移，外形美观，功能良好。供区余轻微瘢痕，肌肉功能良好。结论 游离股动脉穿支皮瓣可用于修复口颊癌根治术后局部缺损。

Clinical application of free femoral artery pedicled perforator flap in the repair of postoperative defect of oral and buccal carcinoma

Objective To investigate the clinical anatomy of free femoral artery perforator flap and its application in postoperative defect repair after resection of oral and buccal carcinoma.Methods From Dec 2015 to June 2019, 13 male patients with oral and buccal carcinoma underwent postoperative defect repair with free femoral artery perforator flap. All the patients aged from 37 to 61 years old, with an average of 48.5. The pathological type was squamous cell carcinoma. According to TNM staging, 5 cases were at T4N0M0, 2 at T4N1M0, 2 at T3N1M0, and 4 at T3N2M0. The disease course ranged from 3 to 16 months, with an average of 9.8. The specific forms of free femoral artery perforator flap included pure perforator flap in 7 cases and perforator chimera muscle ator flap in 6.Results The intraoperative planning flap size ranged from 6.5 cm×4.0 cm to 10.0 cm×6.5 cm with thickness of 2.5~3.5 cm. The vessel length of femoral artery perforator was (6.2±0.4) cm, and the donor sites were closed by gathering suture. The flaps survived in all the 13 cases with primary healing of the recipient and donor sites. Patients were followed up from 12 to 30 months, with an average of 21.3 months. The reconstructed oral cavity had satisfied appearance and good function without swelling or deviation. The donor sites remained good muscle function with slight scar.Conclusion Free femoral artery perforator flap can be used to repair local defect after radical resection of oral and buccal carcinoma.