摘要
目的探讨股前外侧穿支皮瓣移植修复头面颈部皮肤恶性肿瘤根治性切除后创面的临床效果。方法该研究为回顾性观察性研究。2020年5月—2023年12月,喀什地区第一人民医院烧伤整形外科收治27例符合入选标准的头面颈部皮肤恶性肿瘤患者,其中男19例、女8例,年龄53~89岁。肿瘤为鳞状细胞癌者21例、基底细胞癌者6例。肿瘤根治性切除后创面面积为9.0 cm×7.0 cm~27.0 cm×21.5 cm。采用分叶、组合或多种形式联合的股前外侧穿支皮瓣修复创面,单侧供区皮瓣切取面积为10.0 cm×8.0 cm~27.0 cm×11.0 cm。将26例患者供区创面拉拢缝合,1例患者供区创面取小腿中厚皮修复。观察术后皮瓣成活情况、血管危象和感染发生情况。术后随访时,观察肿瘤复发情况、皮瓣外形和质地、供区所在肢体功能及瘢痕形成情况。结果仅1例患者术后27 h出现皮瓣静脉危象,经血管探查并重新吻合静脉后皮瓣成活;其余患者术后皮瓣完全成活。1例患者术后皮瓣下出现感染积液,经换药治疗后愈合。术后随访6~36个月,未见肿瘤复发;皮瓣外观、质地及弹性良好;供区所在肢体功能正常,仅遗留线性瘢痕。结论对于头面颈部皮肤恶性肿瘤根治性切除后的复杂创面,可根据创面情况采用不同形式股前外侧穿支皮瓣修复,术后受区创面愈合良好,供区损害小。
Objective To investigate the clinical effects of the anterolateral thigh perforator flaps transplantation in repairing the wounds after radical resection of skin malignant tumors in the head,face,and neck.MethodsThis study was a retrospective observational study.From May 2020 to December 2023,27 patients with skin malignant tumors in the head,face,and neck were admitted to the Department of Burns and Plastic Surgery of the First People's Hospital of Kashi Prefecture,including 19 males and 8 females,aged 53 to 89 years.There were 21 cases with squamous cell carcinoma and 6 cases with basal cell carcinoma.The wound area after radical resection of tumors was 9.0 cm×7.0 cm to 27.0 cm×21.5 cm.The wounds were repaired with the lobulated,combined,or various forms of combination of the anterolateral thigh perforator flaps,and the harvesting flap area in single donor site was 10.0 cm×8.0 cm to 27.0 cm×11.0 cm.The wounds in the flap donor sites were closed by suturing in 26 patients,while the wound in the flap donor site in 1 patient was repaired with medium-thickness skin graft in the lower leg.The survival of the flap,and the occurrence of vascular crisis and infection were observed after surgery.During follow-up after surgery,the tumor recurrence,shape and texture of the flaps,and the function and scar formation of the limbs where the donor site was located were observed.ResultsOnly one patient developed venous crisis of the flap 27 hours after surgery,and the flap survived after vascular exploration and reanastomosis of the vein;the flaps in the other patients survived after surgery.One patient had an infected effusion under the flap after surgery,which healed after dressing change.After 6-36 months of postoperative follow-up,no tumor recurrence was observed;the flap had good appearance,texture,and elasticity;the limb where the donor site was located functioned normally,with only linear scars left.ConclusionsFor complex wounds after radical resection of skin malignant tumors in the head,face,and neck,different forms of anterolateral thigh perforator flaps can be used to repair the wounds according to the condition of the wounds,and the wounds in the recipient sites heal well after surgery,with minimal damage to the donor site.
作者
孙向东
李成志
悟拉木·艾力
麦吉米·司马义
达成利
张兴琴
艾合麦提江·艾合太尔
阿布都赛米江·阿西木
吴源泉
Sun Xiangdong;Li Chengzhi;Wulamu Aili;Maijimi Simayi;Da Chengli;Zhang Xingqin;Aihemaitijiang Aihetaier;Abudusaimijiang Aximu;Wu Yuanquan(Department of Burns and Plastic Surgery,the First People's Hospital of Kashi Prefecture,Kashi 844000,China;Department of Oral and Maxillofacial Surgery,the First People's Hospital of Kashi Prefecture,Kashi 844000,China;Department of Operating Theatre,the First People's Hospital of Kashi Prefecture,Kashi 844000,China;Department of General Surgery Center,the First People's Hospital of Kashi Prefecture,Kashi 844000,China)
出处
《中华烧伤与创面修复杂志》
北大核心
2025年第1期28-35,共8页
Chinese Journal of Burns And Wounds
基金
喀什地区科技局2021年科技计划项目(KS2021079)。
作者简介
通信作者:吴源泉,Email:wyqksrmyy@163.com。
