颊脂垫瓣在口腔肿瘤切除后缺损修复中的应用

目的：研究带蒂颊脂垫修补口腔内肿瘤切除后组织缺损的效果。方法：对15例口腔内肿瘤切除后组织缺损的患者,采用颊脂垫瓣修复组织缺损并观察其疗效。结果：术后创口均甲级愈合,6～8周颊脂垫瓣完全上皮化,2月后上皮化粘膜类似正常口腔粘膜。结论：应用颊脂垫瓣修复口腔内肿瘤切除后组织缺损,其操作简单,创伤小,修复功能恢复好,值得临床推广应用。     

颊脂垫瓣住口腔肿瘤切除后缺损修复中的应用

目的:研究带蒂颊脂垫修补口腔内肿瘤切除后组织缺损的效果.方法:对15例口腔内肿瘤切除后组织缺损的患者,采用颊脂垫瓣修复组织缺损并观察其疗效.结果:术后创口均甲级愈合,6～8周颊脂垫瓣完全上皮化,2月后上皮化粘膜类似正常口腔粘膜.结论:应用颊脂垫瓣修复口腔内肿瘤切除后组织缺损,其操作简单,创伤小,修复功能恢复好,值得临床推广应用.     

带蒂颊脂垫组织瓣修复腭部缺损患者的护理

带蒂颊脂垫组织瓣移植是修复腭部软组织缺损的一种新方法,该手术能即刻修复肿瘤切除术后腭部缺损,改善患者口腔功能,提高其生活质量。1988年11月至1999年10月,我科采用无覆盖带蒂颊脂垫组织瓣移植修复腭部肿瘤术后缺损患者76例,获得较满意的效果。护理体会总结如下。1　临床资料1.1　一般资料本组76例,男31例、女45例,年龄30～72岁,平均51.0岁。腭部鳞状细胞癌34例,腺样囊性癌10例,腺癌9例,粘液表皮样癌8例,乳头状腺癌6例,恶性黑色素瘤5例,白斑恶变4例。缺损范围:2.5cm×2.0cm～5.0cm×4.0cm。76例中腭部洞穿性缺损46例;应用一侧带蒂颊脂垫…     

带蒂颊脂垫移植的临床应用

口腔颌面部软组织缺损的修复应用脂肪移植时，供区主要是腹部或臀部的游离脂肪，临床上很少应用带蒂颊脂垫移植。作者做了２０侧头部尸体解剖，并对口腔颌面部恶性肿瘤根治术２８例活体进行观察，对带蒂颊脂垫的应用解剖做了研究。１９８８年以来，应用带蒂颊脂垫移植修复...     

带蒂组织瓣转移手术修复肢体软组织缺损35例分析

目的　分析带蒂组织瓣转移手术修复肢体软组织缺损创面的疗效。方法　选择肌瓣、岛状皮瓣、岛状肌皮瓣转移 ,直接修复缺损或转移肌瓣表面植皮覆盖。结果　 2 9例慢性骨髓炎和 6例外伤后软组织缺损创面 ,肌瓣、岛状皮瓣、岛状肌皮瓣转移修复疗效满意。结论　带有营养血管的肌瓣、皮瓣肌皮瓣转移手术 ,一期修复肢体创伤、骨髓炎等所致的骨缺损腔及软组织缺损创面 ,效果好 ,因不需吻合血管 ,手术相对简单 ,临床使用安全。     

预成钛网结合颊脂垫瓣和自体植骨修复上颌骨缺损

目的介绍一种以钛网支架结合带蒂颊脂垫瓣和自体植骨移植,行上颌骨缺损个体化三维重建的手术方法。方法自2001年5月迄今,对16例上颌骨因肿瘤及外伤后缺损者,分别以三维CT及快速原型技术预成实体模型,通过CAD/CAM将健侧上颌骨复制到患侧缺损部位,在模型上塑形精确钛网,结合带蒂颊脂垫瓣内衬钛网内侧,行自体植骨以重建上颌骨形态和功能。结果16例上颌骨缺损于修复术后6-36个月随访观察,创口均一期愈合,面部轮廓对称,进食时无食物从鼻腔返流。16例中8例钛网支架结合带蒂颊脂垫瓣移植并行自体植骨上颌骨缺损重建者,已行可摘局部义齿修复,能进普食,语言清晰,活动义齿修复功能良好。3例上颌骨功能性重建术后5-12个月经鼻咽内窥镜检查,发现钛网内衬有正常软组织覆盖。结论本手术方法使术后患者上颌骨外形和口腔功能得到改善,且将带蒂颊脂垫植入上颌窦黏膜与钛网之间,避免了移植物的暴露,血管化的颊脂垫不仅有助于自体骨与钛网支架较好的结合,同时能恢复部分上颌窦的正常生理功能。     

带皮管蒂前臂皮瓣移植修复颌面部软组织缺损

目的：介绍前臂皮瓣带皮管蒂移植修复颌面部软组织缺损的方法。方法：应用带皮管蒂前辟以瓣移植修复颌面部软组织缺损4例,对其进行临床经验总结,结果：4例皮瓣均成活,软组织缺损修复后外形满意,无感染等并发症。结论：前臂皮瓣带皮管蒂移植解决了受区供给血管限制的问题,拓展了该皮瓣的应用途径,与局部区域条件差,无条件游离使用时,带皮管蒂前臂移植是颌面部软组织缺损修复可供采用的有效方法。     

带血管蒂肌瓣转移用于胫腓骨骨肉瘤保肢术

目的 报告四肢恶性肿瘤广泛切除保肢手术,应用带血管蒂肌瓣修复和重建软组织成功的经验。方法 广泛切除小腿骨肉瘤及瘤周软组织,得用人工假体或吻合血管游离腓骨和移植等方法重建骨骼,局部转移带血管蒂的腓骨肌或比目鱼肌肌瓣,欠组织缺损。结果 临床应用７例,带血管蒂的肌瓣成活良好,无切口并发症,膝关节活动度提高,假体表面皮肤移动性良好。结论 带血管蒂的肌瓣在胫腓骨恶性肿瘤的保肢术中,对于重建软组织缺损和保证切     

颞筋膜瓣带蒂转移在眼睑皮肤软组织大面积缺损修复中的应用

目的:探讨颞筋膜瓣带蒂转移联合全厚皮片移植修复外伤性眼睑皮肤软组织缺损的临床应用效果。方法:设计与转移颞筋膜瓣联合全厚片移植修复外伤性眼睑皮肤软组织缺损12例。结果:12例外伤性眼睑皮肤软组织缺损患者,颞筋膜瓣与移植皮片成活良好,且取得了满意的修复效果。结论:颞筋膜瓣修复外伤性眼睑皮肤软组织缺损,安全可靠,效果确切,为外伤性睑皮肤软组织缺损修复提供了一个新途径。     

颊脂垫瓣移转在腭裂修复中的应用

目的介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法将颊脂垫瓣移植于硬腭裂隙的口腔侧创面，或充填于腭部的口腔与鼻腔侧组织瓣之间，尤其是硬软腭交界处。颊脂垫不需用皮片覆盖，可以自行上皮化。结果共治疗腭裂６例，术后颊脂垫完全成活，无腭瘘形成，无颊间隙感染发生。２周后，颊脂垫自行上皮化。结论颊脂垫血供丰富，易于成活，可为Ⅱ期愈合的创面提供肉芽组织再生床，改善软硬组织血供，以促进伤口的愈合。使通过常规的手术方法不能或难以修复的大的裂隙或缺损得以修复     

Pedicled buccal fat pad flap for intraoral malignant defects: A series of 29 cases

A buccal fat pad (BFP) as a flap for reconstruction of defects in the oral cavity has been described for a variety of benign conditions. We describe the indications, advantages, and complications of the BFP flap and report our clinical experience with the flap for intraoral reconstruction after tumor removal. From 2005 to 2008, we analyzed 29 patients in the age range of 32 to 82 years old who underwent a pedicled BFP flap reconstruction for oral defects after intraoral tumor removal. Postoperative wound healing and complications including any recurrence was followed-up prospectively. Most of the patients had an uneventful immediate postoperative period with signs of buccal fat pad epithelialization by the end of the first week and complete epithelialization at the end of the first month. On continued follow-up, a linear band of fibrous tissue under the epithelialized mucosa replaced the once reconstructed buccal fat pad. Three patients had varying degrees of hemorrhage: one of them had hematoma that healed with severe fibrosis and of the remaining two, one had a partial flap loss and one had a complete flap loss. Judicious use of buccal fat pad reconstruction offers a simple, convenient, and reliable way to reconstruct small to medium defects of the oral cavity with low morbidity, even in older patients who would not be able to tolerate time-consuming flap reconstruction procedures.     

颊脂垫瓣移转在腭裂修复中的应用

介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法 将颊脂垫瓣移植于硬腭裂隙的口腔侧创面，或充填于腭部的口腔与鼻腔侧组织瓣之间，尤其是硬软腭交界处。颊脂垫不需用皮片覆盖，可以自行上皮化。结果 共治疗腭裂６例，术后颊脂垫完全成活，无腭瘘形成，无颊间隙感染发生。     

颊脂垫瓣移转在腭裂修复中的应用

目的介绍颊脂垫辦移转的应用原理及用以腭裂修复的实践。方法将颊脂垫瓣移植于硬腭裂隙的口腔侧创面,或充填于腭部的口腔与鼻腔侧组织辦之间,尤其是硬软腭交界处。颊脂垫不需用皮片覆盖,可以自行上皮化。结果共治疗腭裂6例,术后颊脂垫完全成活,无腭瘘形成,无颊间隙感染发生。2周后,颊脂垫自行上皮化。结论颊脂垫血供丰富,易于成活,可为Ⅱ期愈合的创面提供肉芽组织再生床,改善软硬组织血供,以促进伤口的愈合。使通过常规的手术方法不能或难以修复的大的裂隙或缺损得以修复。     

颊脂肪垫瓣在修复口腔颌面部缺损中的应用

目的探讨颊脂肪垫瓣在修复口腔颌面部缺损的应用和效果.方法将颊脂肪垫形成一蒂在后方的颊脂肪垫组织瓣转移至缺损区,在无张力下与创缘缝合,表面轻轻用碘仿纱布缝线包压法固定.用以修复口腔颌面部的良恶性肿瘤手术或损伤留下的缺损以及口腔上颌窦瘘共18例.其中修复腭部缺损2例,上颌骨切除后缺损7例,颊黏膜癌切除后缺损3例,颊部良性肿瘤切除后缺损4例,磨牙后区黏表癌切除后缺损1例,封闭拔牙后口腔上颌窦瘘1例.结果术后10 d去除碘仿纱布,见颊脂肪垫轻度水肿,2～4周后水肿明显消退,颊脂肪垫表面逐渐上皮化,6～8周内表面完全上皮化,3个月后再生黏膜与正常口腔黏膜相似.全部病例效果满意,无感染、坏死等并发症发生.结论带蒂颊脂肪垫瓣修复口腔颌面部缺损,方法简单、易行,效果满意,值得推广.     

颊脂垫瓣在口腔缺损修复中的应用

目的评价颊脂垫瓣在修复口腔黏膜缺损中的应用。方法1998年5月~2004年7月,收治42例各种原因致口腔缺损患者,其中男26例,女16例,年龄25~76岁。颊部鳞癌7例,颊部白斑5例,软腭部鳞癌7例,腭部腺样囊性癌8例,上颌窦癌6例,上颌齿槽突血管瘤5例,上颌骨角化囊肿4例。病程2个月~10年。缺损部位颊部12例,上颌骨切除导致颊部上分缺损6例,口腔上颌窦瘘17例,软腭部缺损7例。缺损范围3.0cm×3.0cm~6.5cm×4.0cm。均采用颊脂垫瓣修复缺损部位,切取的颊脂垫瓣为颊脂垫的颊突及部分体部。结果术后41例颊脂垫瓣与创面期愈合;1例因缺损大,瓣成形后较薄而期愈合。术后4周水肿消退逐渐上皮化,6周完全上皮化,颊部外观无明显影响。35例获随访3个月~5年,颊脂垫瓣修复区与附近正常黏膜的层次和颜色、弹性、光滑度、质地无明显差异,咀嚼摩擦和食物刺激无明显影响。2例磨牙后区缺损者有轻度张口受限,经过开口训练恢复张口度。结论颊脂垫瓣能较快而有效地修复直径6.5cm以下的黏膜缺损,取材方便,术后无明显的供区并发症,是修复颊部、软腭和牙槽等部位黏膜缺损的理想组织。其缺点为修复范围较局限。     

Buccal fat pad - a simple, underutilised flap

The pedicled buccal fat pad is a reliable flap for the repair of small oral defects. It is durable, easy to harvest and should be considered in settings where access to free flaps is limited and in cases where previous flaps have failed. We discuss a case where this flap was used successfully for closure of an oro-antral fistula. The indications, anatomy and techniques of successful harvest are discussed.     

The hypothenar fat pad transposition flap: a modified surgical technique

The hypothenar fat pad flap has been shown to produce reliable clinical results for the treatment of recurrent carpal tunnel syndrome secondary to cicatricial tethering. The flap utilizes soft vascularized tissue that does not compromise hand function and is of sufficient size to provide median nerve coverage in the carpal tunnel. We describe technical modifications that facilitate improved, tension-free transposition of the pedicled fat pad flap. These modifications enable transfer of vascularized tissue and decrease iatrogenic damage to the important perforator vessels. The hypothenar fat pad transposition flap provides a reliable source of vascularized local tissue that can be used successfully as an adjunct to neurolysis for the treatment of recurrent idiopathic CTS secondary to perineural scarring.     

The buccal fat pad in oral reconstruction.

We describe the indications, advantages, and complications of the buccal fat pad (BFP) flap and report our clinical experience with the flap for intraoral reconstruction after tumour removal. METHODS: From 1993 to 2002, a pedicled BFP flap was used to reconstruct oral defects after tumour removal in 15 patients, prospectively analysed. RESULTS: Adequate closure of the defect was achieved. In seven cases there was some retraction of the BFP. CONCLUSIONS: The BFP, as a flap, offers a good and simple option in the reconstruction of small to medium defects in the oral cavity, above all in older patients. The greatest disadvantage is that reduction in oral opening could occur, to an unpredictable degree.     

Plantar heel reconstruction with a sensate plantar medial artery musculocutaneous pedicled island flap after wide excision of melanoma

Reconstruction of soft tissue defects in the plantar heel pad presents a surgical challenge that requires replacing the lost tissue with another tissue having similarly unique physical characteristics. This case report describes a reconstruction of the plantar heel pad after wide excision of a heel melanoma, using a sensate plantar medial artery musculocutaneous pedicled island flap.