穿支皮瓣移植修复头颈肿瘤术后洞穿性缺损

目的探讨穿支皮瓣在修复头颈肿瘤术后洞穿性缺损中的应用。方法对2006年1月至2008年3月，采用穿支皮瓣同期修复头颈肿瘤术后洞穿性缺损的29例患者资料进行分析。结果29例患者中，2例出现血管危象，1例皮瓣部分坏死，6例出现早期局部并发症。术后随访3个月至2年（平均14个月）。本组中，20例术后头颈部外形及功能基本恢复正常，受区和供区均无严重并发症；2例带瘤生存；7例分别因局部复发、颈淋巴结转移及远处转移等死亡。结论利用吻合血管的穿支皮瓣，更易于塑形修复，且供区并发症较少，是修复各种头颈肿瘤术后洞穿性缺损的良好方法。

Clinical Application of Perforator Flaps for the Reconstruction of Perforating Defects in the Head and neck

Objective To explore the clinical application of free perforator flaps in the reconstruction of perforating defects following the ablation of head and neck tumor. Methods From Jan. 2006 to Mar. 2008, 29 patients with perforating defects in the head and neck were treated by free perforated flaps. Results Among 29 free perforator flaps, vascular crises occurred in 2 cases. One flap was partly necrosis. Early local complications occurred in 6 cases. Patients were followed up for 3-24 months （14 months on average）. The figure and feeling were satisfactory. No severe complications occurred in both donor and recipient site. Two patients survived with tumor. Seven patients died of local recurrence, cervical and distant metastasis. Conclusion The operation of repairing perforating defects in the head and neck with perforator flaps can effectively recover appearance. It could decrease the mobility rate and shorten the treatment period. Perforator flap was the new and reliable technique for reconstruction of tissue and may be one of the primary choices in the future.