个体化设计前臂皮瓣修复口腔缺损的临床观察

目的:探讨前臂皮瓣修复口腔缺损时,为适应缺损的个体化需要而设计皮瓣形状的可行性。方法:应用前臂皮瓣修复口腔缺损40例。设计方法,术前根据肿瘤的范围和预计手术造成的缺损大小和外形,结合血管蒂的走行方向在前臂设计皮肤的形状,再设计皮下筋膜层的外形,皮下筋膜层的范围要包括桡动脉和头静脉在内,大于皮肤范围。术后1周、3个月、6个月评价皮瓣在口腔内的外形。结果:31例皮瓣修复成功,3例皮瓣完全坏死,6例皮瓣外形臃肿、牵拉影响口腔功能。结论:前臂皮瓣修复口腔缺损时如果带有范围较大的皮下筋膜层,且筋膜层将桡血管和头静脉血管网包括在内,进行适形设计是非常安全的。

Custom-made Forearm Flap in the Restoration of Oral Defects

Objective: To investigate the feasibility of custom-made forearm flap in the restoration of oral defects. Methods: 40 cases of oral defects were restorated by custom-made forearm flaps. In the custom-made flap, subcutaneous fasial tissue containing radius artery and cephalous vein might be larger than superficial cutaneous area. Flaps were checked 1 week, 3 months, and 6 months postoperatively. Results: 3 flaps terminated necrosis; 6 flaps appeared obese and interfere with oral function. Conclusion: Custom-made forearm flap with larger area of subcutaneous fasial tissue including radius artery and cephalous vein is a safe one in the restoration of oral defects.