V型折叠颏下皮瓣修复口腔缺损的临床应用  

Clinical application of V-shaped folded submental flap in the repair of oral defect

作　　者：卢若煌[1] 邓浩斌 郭新程[1] 戴捷[2] 甘平平[3] LU Ruohuang;DENG Haobin;GUO Xincheng;DAI Jie;GAN Pingping(Department of Stomatology,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Head and Neck Surgery/Oncoplastic Surgery,Hunan Cancer Hospital,Changsha 410006;Department of Oncology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅三医院口腔科,长沙410013 [2]湖南省肿瘤医院头颈外科/肿瘤整形外科,长沙410006 [3]中南大学湘雅医院肿瘤科,长沙410008

出　　处：《中南大学学报（医学版）》2024年第2期273-278,共6页Journal of Central South University ：Medical Science

基　　金：湖南省重点研发计划(2018SK2122);湖南省卫生健康委员会科研课题(20232757)。

摘　　要：目的:口腔中小型缺损修复一直是一个难题,游离皮瓣和远位带蒂组织瓣难以满足临床需求,传统颏下皮瓣存在供区损伤风险。本研究旨在探讨V型折叠颏下皮瓣修复口腔中小型缺损的疗效。方法:回顾性分析2019年3月至2022年12月中南大学湘雅三医院口腔科收治的28例口腔黏膜病变患者的临床资料。根据颏下皮瓣手术方式的不同将患者分为V型折叠组(17例)和传统组(11例),V型折叠组采用V型折叠颏下皮瓣进行术后软组织修复,传统组采用传统颏下皮瓣进行修复,患者术后随访6~48个月。比较2组皮瓣存活情况、皮瓣修复时间以及皮瓣修复效果。结果:2组皮瓣存活率、皮瓣大小、制瓣时间、修复手术时间和术后住院时间差异均无统计学意义(均P>0.05)。术后6个月,V型折叠组无抬头困难和下唇外翻,无皮肤“猫耳”畸形,疤痕隐藏于下颌骨下缘处,创面美观度、功能评分均明显高于传统组(均P<0.05)。结论:V型折叠颏下皮瓣具有设计灵活、制备简单、血供可靠、保护供区等优点,可以有效维持颏部美观和避免功能障碍。Objective:The repair of small and medium-sized defects in the oral has always been a challenge,free skin flap and distal pedicled tissue flaps are difficult to meet clinical needs,and the traditional under-chin flap has the risk of donor-area injury.This study aims to investigate the efficacy of V-shaped folded submental flap in the repair of small-sized and medium-sized oral defects.Methods:The clinical data of 28 patients with oral defect lesions,who were hospitalized in the Department of Stomatology,Third Xiangya Hospital of Central South University from March 2019 to December 2022,were retrospectively analyzed.Patients were divided into a V-shaped folded group(17 cases)and a conventional group(11 cases)according to different surgical methods.The V-shaped folded group was treated with a V-shaped folded submental flap for postoperative soft tissue repair,while the conventional group was treated with a conventional submental flap for repair.The postoperative follow-up time was 6−48 months.The survival status,repair time,and repair effect of the 2 groups were compared.Results:There was no significant difference in flap survival rate,flap size,flap preparation time,repair surgery time,and postoperative hospital stay between the 2 groups(all P>0.05).At 6 months after the surgery,the V-shaped folded group had no difficulty in raising the head or everting the lower lip,no“cat ear”deformity in the submental skin.Scars in the V-shaped folding group were hidden at the lower edge of the mandible.The wound aesthetics and functional scores in the V-shaped folded group were significantly higher than those in the conventional group(both P<0.05).Conclusion:The V-shaped foldable submental flap has the advantages of flexible design,simple preparation,reliable blood supply,and protection of the donor area,which can effectively protect the appearance of the chin and avoid functional disorders.

关 键 词：V型折叠颏下皮瓣 黏膜缺损 创面修复 

分 类 号：R781[医药卫生—口腔医学]