胸大肌皮瓣修复口腔颌面部大型缺损的临床体会

目的探讨胸大肌皮瓣修复口腔颌面部恶性肿瘤术后大型缺损的临床效果。方法27例口腔颌面部恶性肿瘤患者术后缺损采用胸大肌皮瓣修复，皮瓣切取大小为6cm×4cm~11cm×9cm。26例修复口内缺损，1例修复面部缺损。17例经锁骨上、10例穿锁骨下进入颈部。结果术后20例完全成活（74.1%），6例部分坏死（22.2%），1例完全坏死（3.7%）。13例出现术后并发症（48.1%）：10例（37.0%）为伤口感染，其中受区感染8例，供区感染2例，7例皮瓣坏死的患者均出现受区伤口感染；其他并发症包括伤口裂开、颈部血肿及肺感染各1例（3.7%）。结论为避免皮瓣坏死及减少受区伤口感染，应按照胸大肌皮瓣的血供...

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Bibliographic Details
Published in天津医药 Vol. 44; no. 8; pp. 1026 - 1028
Main Author 张学伟;国美丽;王志兴;沈军;张建成;张军;穆杰;严颖彬
Format Journal Article
LanguageChinese
Published 天津市口腔医院口腔颌面外科 邮编300041%天津市第五中心医院口腔科 2016
Subjects
手术后并发症;修复外科手术;胸大肌皮瓣;坏死;口腔颌面部肿瘤;缺损
reconstructive surgical procedures
口腔颌面部肿瘤
手术后并发症
necrosis
坏死
pectoralis major myocutaneous flap
defects
postoperative complications
缺损
修复外科手术
oral and maxillofacial tumors
胸大肌皮瓣
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ISSN0253-9896
DOI10.11958/20150430

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Summary:目的探讨胸大肌皮瓣修复口腔颌面部恶性肿瘤术后大型缺损的临床效果。方法27例口腔颌面部恶性肿瘤患者术后缺损采用胸大肌皮瓣修复，皮瓣切取大小为6cm×4cm~11cm×9cm。26例修复口内缺损，1例修复面部缺损。17例经锁骨上、10例穿锁骨下进入颈部。结果术后20例完全成活（74.1%），6例部分坏死（22.2%），1例完全坏死（3.7%）。13例出现术后并发症（48.1%）：10例（37.0%）为伤口感染，其中受区感染8例，供区感染2例，7例皮瓣坏死的患者均出现受区伤口感染；其他并发症包括伤口裂开、颈部血肿及肺感染各1例（3.7%）。结论为避免皮瓣坏死及减少受区伤口感染，应按照胸大肌皮瓣的血供特点设计皮瓣并保护好血管蒂。
Bibliography:postoperative complications;reconstructive surgical procedures;pectoralis major myocutaneous flap;necrosis;oral and maxillofacial tumors;defects
Objective To summarize the clinical outcomes of pectoralis major myocutaneous flap for repairing large defects in oral and maxillofacial area after resection of malignant tumor. Methods The clinical data of 27 patients underwent resection of malignant tumor in oral and maxillofacial area and reconstructed with pectoralis major myocutaneous flap were collected in our hospital from August 1998 to January 2015. The pectoralis major myocutaneous flaps were harvested with sizes ranging from 6 cm×4 cm to 11 cm×9 cm. The major myocutaneous flaps were used to reconstruct the defects of oral mucosa in 26 cases, and flap was used to reconstruct the defect of facial skin in 1 case. Seventeen major myocutaneous flaps reached the neck via the subclavicular tunnel, the other 10 were transferred over the clavicle. Results After surgery, 20 flaps (74.1%) were survived completely, 6 w
ISSN:0253-9896
DOI:10.11958/20150430