面颌部洞穿缺损的双皮瓣及肌皮瓣修复

目的为解决由各种原因引起的面颌部洞穿性缺损的修复问题。方法采用两个带蒂的组织瓣搭配使用修复面颌部洞穿缺损45例,共用组织瓣90个。其中胸三角皮瓣58个(占64%),依次是颈阔肌肌皮瓣,胸大肌肌皮瓣,额部皮瓣,胸锁乳突肌肌皮瓣,背阔肌肌皮瓣等。结果45例洞穿性缺损所用90个组织瓣中全部成活及绝大部分成活者87个,成活率达97%,全部或大部分坏死的3个(占3%)。结论面颌部洞穿性缺损即刻修复是可行的。修复洞穿缺损有多种皮瓣、肌皮瓣可供选择;提出胸三角皮瓣、颈阔肌肌皮瓣、胸大肌肌皮瓣等是修复面颌部洞穿性缺损的优质组织瓣。临床应用中取得了功能与外形同时修复的效果。

Reconstruction of perforating defects of the maxillofacial region with double flaps

Objective To solve the problems in restoration of perforating(full thickness)defects in the maxillofacial region.Methods Double flaps have been used to reconstruct the defects.Forty-five pa- tients with full thickness defects on the maxillofacial region were treated with 90 flaps,including 58 (64%)deltopectoral flaps,the platysma myocutaneous flap,pectoralis major myocutaneous flap,ster- nomastoid myocutaneous flap,forehead flap and latissimus myocutaneous flap.Results The operation re- sults were satisfactory.Of the 90 flaps,87 flaps survived completely or subtotally with a successful rate of 97%.Three flaps sustained total or large necrosis.Conclusion A number of flaps can be used for repairing the full thickness defects of the maxillofacial region,especially the deltopectoral flap,the platysma myocu- taneous flap and the pectoralis major myocutaneous flap.They can provide excellent external cover or inter- nal lining.They are well vascularized,hairless and colour-matched.