口腔医学研究

口腔医学研究 ›› 2020, Vol. 36 ›› Issue (4): 346-349.DOI: 10.13701/j.cnki.kqyxyj.2020.04.010

• 口腔颌面外科学研究 • 上一篇    下一篇

显微修薄股前外侧皮瓣在口腔颌面软组织缺损中的临床应用

孙黎波1,2, 兰玉燕3*, 周航宇1,2, 付光新1,2, 王雷1,2, 姚志浩1,2   

  1. 1.西南医科大学附属口腔医院口腔颌面外科 四川 泸州 646000;
    2.西南医科大学附属医院口腔颌面外科 四川 泸州 646000;
    3.西南医科大学口颌面修复重建和再生实验室 四川 泸州 646000
  • 收稿日期:2019-07-15 出版日期:2020-05-28 发布日期:2020-05-28
  • 通讯作者: 兰玉燕,E-mail:slb-324324@163.com
  • 作者简介:孙黎波(1979~ ),男,辽宁朝阳人,硕士,副主任医师,主要从事口腔颌面缺损修复的临床研究。
  • 基金资助:
    四川省医学会青年项目(项目编号:Q18011); 四川省泸州市科技局项目[编号:2015-S-50(1/3)]; 四川省泸州市科技局项目[编号:2017-S-42(1/2)]

Application of Microdissected Thin Anterolateral Thigh Flap in Oral and Maxillofacial Soft Tissue Defects

SUN Libo1,2, LAN Yuyan3* , ZHOU Hangyu1,2 , FU Guangxin1,2, WANG Lei1,2, YAO Zhihao1,2   

  1. 1. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Southwest Medical University, Luzhou 646000,China;
    2. Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou 646000,China;
    3. Orofacial Reconstruction and Regeneration Laboratory, Southwest Medical University, Luzhou 64600, China
  • Received:2019-07-15 Online:2020-05-28 Published:2020-05-28

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摘要： 目的: 探讨显微修薄股前外侧皮瓣在口腔颌面软组织缺损修复中的临床效果。方法: 以2015年12月~2018年5月期间56例行股前外侧皮瓣修复手术的患者,术前常规行股前区CT血管造影,利用影像工作站(Philips Medical Systems)定位穿支血管出肌点的体表位置,以其为中心设计个性化皮瓣,模拟切取皮瓣,并对其周界脂肪厚度进行测量,对皮下脂肪较厚的15例患者,应用手术显微镜对皮瓣进行修薄后转移至受区进行外科修复。结果: 显微修薄股外侧皮瓣14例完全存活,1例皮瓣远端出现坏死,经换药后愈合。切取皮瓣面积最大9 cm×5 cm,面积从最小6 cm×4 cm,供区无运动感觉功能障碍,并且避免二期去脂手术。结论: CT血管造影能够指导股前外侧皮瓣的制备,对于皮下脂肪较厚的患者,显微修薄股前外侧皮瓣修复口腔颌面软组织缺损可以获得理想的临床效果。

关键词: CT血管造影, 股前外侧皮瓣, 软组织缺损

Abstract: Objective: To explore the application of microdissected thin anterolateral thigh flap in the repair of oral and maxillofacial soft tissue defects. Methods: From December 2015 to May 2018, 56 patients with oral and maxillofacial soft tissue defects were included. Preoperative CT angiography was conducted. Imaging workstations (Philips Medical Systems) were used to locate perforating vessels, design personalized flaps, simulate flaps cutting, and measure the fat thickness of the flaps. For 15 patients with thick subcutaneous fat, the adipose tissue was dissected after verifying the distribution of the blood vessels using an operating microscope. The whole flap was transposed to the recipient areas for microsurgical reparation. Results: 14 flaps survived completely. Only 1 flap suffered partial margin necrosis, which was healed after dressing change. The flap ranged from 9 cm×5 cm to 6 cm×4 cm in size. Donor recipient site was not severe complications, and secondary operative procedure was not needed in any patient in the follow-up. Conclusion: CT angiography can effectively guide the design of anterolateral thigh flap. For patients with thicker subcutaneous fat, microdissected thin anterolateral thigh flap was safe and reliable for patients with oral and maxillofacial soft tissue defects.

Key words: CT angiography, anterolateral thigh flap, soft tissue defect