游离组织瓣修复头颈部缺损手术后的管理

目的 :探讨头颈部游离组织瓣移植围手术期的管理 ,形成临床常规。方法 :3 3例游离组织瓣显微血管吻合修复面颈部缺损 ,对其围手术期所发生的问题进行分类 ,分析可能影响组织瓣成活的各种因素、围手术期用药及处理。结果 :3 3例游离组织瓣 3 2例成功 ,1例失败 ,成功率为 97.0 %。 2例出现静脉血栓 ,组织瓣血栓的发生率为 6.1% ,重新手术探查吻合 ,1例成功 ,另 1例坏死 ,抢救成功率为50 %。术后并发症的发生率为 3 6.4%。结论 :游离组织瓣移植最易出现的并发症是血管危象和血肿 ,及时处理可防止组织瓣坏死

Postoperative management of free flap transfer for the repair of the defects in head and neck region

Objective:To summarize the experience in the postopera ti ve management of free flap transfer for the repair of the defects in head and ne ck region. Methods:Thirty three free flaps were transfere d to repair head and neck defects.The factors that may influence the survive of the flaps,and the way that may be used to handle those problems were analyzed. Result: Thirty two of the thirty three free flaps surviv ed and one was lost. The overall free flap success rate was 97.0% .Thrombosis of vein developed in 2 patients. By flap salvage, one flap survived,the other ex perienced total failure. The total postoperative complication rate was 36.4% inc luding thrombosis,infection,bleeding,wound break and so on.Corresponding treatme nt was given and all the flaps were kept except one mentioned above. Conclution:The most common complications in free flaps transfer are v essel thrombosis and hematoma. Timely salvage can prevent the necrosis of the flaps