游离股深动脉蒂股薄肌嵌合肌皮穿支皮瓣修复口颊癌术后缺损  

Free profunda femoral artery pedicled gracilis chimeric myocutaneous flap in the reconstruction of defect after buccal mucoca squamous cell carcinoma resection

作　　者：宋达疆[1] 李赞[1] 周晓[1] 章一新[2] 彭小伟[1] 周波[1] 吕春柳[1] 彭文[1] 王旭[1] 欧延[1] 

机构地区：[1]湖南省肿瘤医院肿瘤整形外科,410008 [2]上海交通大学医学院附属第九人民医院整形外科

出　　处：《中华整形外科杂志》2017年第4期242-247,共6页Chinese Journal of Plastic Surgery

基　　金：湖南省自然科学基金面上项目（13JJ5012）;湖南省科技计划项目（2014SK3002）;湖南省卫计委课题项目（B2014-111）

摘　　要：摘要 目的探讨游离股深动脉蒂股薄肌嵌合肌皮穿支皮瓣在口颊癌术后缺损修复中的应用。 方法2014年1月至2016年5月，应用股深动脉蒂股薄肌嵌合肌皮穿支皮瓣对12例口颊癌根治术患者同期行口颊缺损修复，口底腔隙同时用肌瓣充填。缺损面积为8.0 cm×3.5 cm～9.5 cm×5.0 cm，术前常规以便携式可听多普勒血流探测仪确定大腿内侧区域穿支血管发出位置，以此为皮瓣中心点，以耻骨结节至股骨粗线内侧唇连线为皮瓣轴线，根据肿瘤继发缺损面积和形状设计皮瓣。 结果皮瓣面积为8.0 cm×4.0 cm～10.0 cm×5.5 cm，厚度为（1.8±0.4） cm。股深动脉蒂股薄肌嵌合肌皮穿支皮瓣血管蒂长度为（7.4±0.6） cm。12例嵌合穿支肌皮瓣全部存活，供区均直接闭合。随访10～28个月，平均14.8个月，皮瓣形态良好，吞咽、语言功能满意，肿瘤局部无复发；供区仅遗留线性瘢痕，大腿功能未见明显影响。 结论股深动脉蒂股薄肌嵌合肌皮穿支皮瓣是口颊癌术后复杂缺损修复的较好选择。ObjectiveTo explore the application of free profunda femoral artery pedicled gracilis chimeric myocutaneous flap in the reconstruction of defect after radical resection of buccal mucoca squamous cell carcinoma. MethodFrom January 2014 to May 2016, 12 cases with buccal mucoca squamous cell carcinoma underwent radical resection, leaving buccal mucoca defect which was reconstructed by free profunda femoral artery pedicled gracilis chimeric myocutaneous flap at the same stage. The buccal mucoca defect was reconstructed with skin paddle, the mouth floor cavity was filled with muscular flap. ResultThe Length of free profunda femoral artery pedicled gracilis chimeric myocutaneous flap was （9.0±0.3） cm, the width of flap was （4.5±0.3） cm, the thickness of flap was （1.8±0.4） cm.The length of pedicle was （7.4±0.6） cm.All 12 chimeric perforator flaps survived uneventfully, the defects at the donor sites were closed directly in all cases. All patients were followed up for 10-28 months （14.8 on average） with satisfied esthetic and functional results in flap reconstruction. The swallowing and speech function was satisfactory. No local recurrence happened. Only linear scar was left in the donor sites, the function of thighs was not affected. ConclusionsThe free profunda femoral artery pedicled gracilis chimeric myocutaneous flap is an ideal choice for reconstruction of the defect after radical resection of buccal mucoca squamous cell carcinoma.

关 键 词：穿支皮瓣 股深动脉 嵌合皮瓣 游离皮瓣移植 口颊癌 

分 类 号：R739.8[医药卫生—肿瘤] R782.2[医药卫生—临床医学]