华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

带皮岛游离腓骨骨皮瓣修复颌面部缺损

毛驰 彭歆 俞光岩 郭传滨 张益 黄敏娴 马大权   

  1. 100081  北京大学口腔医学院口腔颌面外科
  • 收稿日期:2002-02-25 修回日期:2002-02-25 出版日期:2002-02-20 发布日期:2002-02-20

The Effectiveness and Reliability of Skin Paddles of Free Fibula Flaps in Reconstruction of Maxillofacial Defects

Mao Chi , Peng Xin , Yu Guangyan , et al   

  1. Peking University School of Stomatology
  • Received:2002-02-25 Revised:2002-02-25 Online:2002-02-20 Published:2002-02-20

摘要:

目的:探讨游离腓骨骨皮瓣皮岛在颌面部缺损修复中的作用及可靠性。方法:对55 例携带皮岛的游离腓骨骨皮瓣,分析所采用皮岛的设计、大小、修复部位及存活情况。结果:55 例游离腓骨骨皮瓣共携带皮岛57 块,其中37 块由1 个穿支供血,18 块由2 个穿支供血,2 块由3 个穿支供血。57 块皮岛中,用于口内缺损修复28 块,口外缺损修复7 块,口内和口外软修复1 块,面部软组织充填2 块,单纯用于游离腓骨骨皮瓣术后血供监测19 块。55 例腓骨瓣中,除1 例因静脉血栓经抢救无效后去除外,其余的54 例56 块皮岛均获得100 %成活。结论:游离腓骨骨皮瓣皮岛的血供安全可靠,其在颌面部缺损的修复中具有很大的灵活性,除软组织缺损的修复外,还可以作为游离腓骨瓣术后的观察窗,用于腓骨瓣血供的监测。

关键词: 游离腓骨骨皮瓣, 皮岛, 显微外科

Abstract:

The paper reviewed the effectiveness and reliability of skin paddles of free fibula flaps in the reconstruction of maxillofacial defects.Methods :Fifty-five consecutive free fibula osteocutaneous flap transfers performed fromJune 21 , 1999 to Oc2 tober 31 , 2000 were reviewed. The skin paddles of each flap were analyzed in terms of surgical design , blood supply , size , recon2 struction location , and survival. Results :Fifty- seven skin paddles were used for the 55 free fibula flaps (double skin paddles for 2 flaps) , 37 were nurtured by one perforator , 18 by two and two by 3 perforators. Twenty-eight skin paddles were used for intraoral reconstruction , 7 for extraoral reconstruction , 1 for both intraoral and extraoral reconstruction , 2 for soft tissue augmentation , and the remaining 19 were simply used as windowfor monitoring the blood flow of fibula flap. One free fibula flap with one skin paddle was lost because of venous thrombosis , and the other 54 flaps survived completely , with 100 % survival of 56 skin paddles.Con2 clusion :The skin paddle of free fibula flap is safe and reliable. It can be used for all kinds of soft tissue reconstruction , as well as window for monitoring the blood flow of fibula flap after operation.

Key words: free fibula flap, skin paddle, microsurgery