旋髂深动脉穿支嵌合髂骨皮瓣修复下颌骨复合性缺损

目的探讨旋髂深动脉穿支嵌合髂骨皮瓣（DCIAPF）在下颌骨复合性缺损重建中的应用价值与优缺点。方法 2014年3—7月应用DCIAPF游离移植一期修复6例下颌骨及软组织复合缺损患者。根据术前定位的旋髂深动脉皮肤穿支设计并逆行切取皮岛,随后于腹股沟区顺行解剖血管蒂并切取髂骨瓣,继续解剖旋髂深血管直至终末段与皮岛相续。完成DCIAPF切取后供区分层严密关闭以预防腹疝。结果 6例患者所制备的髂骨瓣长5.0-11.0 cm,皮岛3.5 cm×5.0 cm-7.0 cm×10.0 cm,供区均一期关闭未行植皮。1例皮岛穿支来自旋髂浅血管需另行吻合,其余5例成功制备为DCIAPF。移植的髂骨皮瓣均成活,仅...

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Published in华西口腔医学杂志 Vol. 33; no. 3; pp. 276 - 280
Main Author 陈洁 蒋灿华 闵安杰 任辉 高政阳 翦新春
Format Journal Article
LanguageChinese
Published 中南大学湘雅医院口腔颌面外科,长沙,410008 2015
Subjects
下颌骨缺损
修复重建
旋髂深动脉
穿支嵌合皮瓣
穿支嵌合皮瓣
mandibular defect
旋髂深动脉
修复重建
reconstruction
deep circumflex iliac artery
chimeric perforator flap
下颌骨缺损
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ISSN1000-1182
DOI10.7518/hxkq.2015.03.013

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Summary:目的探讨旋髂深动脉穿支嵌合髂骨皮瓣（DCIAPF）在下颌骨复合性缺损重建中的应用价值与优缺点。方法 2014年3—7月应用DCIAPF游离移植一期修复6例下颌骨及软组织复合缺损患者。根据术前定位的旋髂深动脉皮肤穿支设计并逆行切取皮岛,随后于腹股沟区顺行解剖血管蒂并切取髂骨瓣,继续解剖旋髂深血管直至终末段与皮岛相续。完成DCIAPF切取后供区分层严密关闭以预防腹疝。结果 6例患者所制备的髂骨瓣长5.0-11.0 cm,皮岛3.5 cm×5.0 cm-7.0 cm×10.0 cm,供区均一期关闭未行植皮。1例皮岛穿支来自旋髂浅血管需另行吻合,其余5例成功制备为DCIAPF。移植的髂骨皮瓣均成活,仅1例因行皮岛修薄处理出现表皮剥脱和少量边缘坏死,经修剪及换药处理后愈合。术后随访3-6个月,牙槽嵴高度恢复满意,供区均未出现明显并发症。结论 DCIAPF血运丰富可靠,能提供足够的骨量供下颌骨重建并恢复牙槽嵴高度,为后期义齿修复创造有利条件;其皮肤穿支解剖较为恒定,携带皮岛组织量大,摆放灵活,供区隐蔽,是下颌骨复合性缺损修复重建的有效方法。
Bibliography:Chen Jie, Jiang Canhua, Min Anjie, Ren Hui, Gao Zhengyang, Jian Xinchun （Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital Central South University, Changsha 410008, China）
51-1169/R
Objective To evaluate the feasibility and outcomes of chimeric deep circumflex iliac artery perforator flap （DCIAPF） applied in the simultaneous reconstruction of the oromandibular defect. Methods Six patients underwent simul-taneous oromandibular reconstruction using DCIAPF following segmental mandibulectomy in Xiangya Hospital from March 2014 to July 2014. The skin paddle was designed to be centered on the pre-operative perforator mapping. Retrograde dissection was performed through the underlying abdominal wall to raise the skin paddle. The pedicle was isolated from the groin, and the iliac crest was cut. The deep iliac circumflex vessels were dissected until the skin paddle was reached. Finally, the donor site was strictly sutured layer by layer to avoid ventral hernia. Results The skin paddles ranged from 3.5 cm×5.0 cm
ISSN:1000-1182
DOI:10.7518/hxkq.2015.03.013