Reconstruction of Orocutaneous Fistula with Medially-based Deltopectoral Flap

利用三角胸肌筋膜皮瓣重建口腔皮膚瘻管

蔡青穎(Chin-Yin Tsai) ； 謝榮賢(Jung-Hsien Hsieh) ； 湯月碧(Yueh-Bih Tang) ； 陳明庭(Ming-Ting Chen)

《中華民國整形外科醫學會雜誌》 14卷4期 (2005/12) Pp. 349-354

https://doi.org/10.7096/JPSA.200512.0349

摘要

口腔皮膚瘻管是口腔癌手術術後重要的併發症之一。小型的瘻管通常對於保守性治療有反應，包括抗生素投予、局部換藥、及營養的補充等。當保守性療法無效時，則應給予病患手術治療，包括局部清創及皮瓣修補。我們提出一種手術方法，將三角胸肌筋膜皮瓣其中一段去表皮化並將整段皮瓣捲起，在口腔皮膚瘻管清創後，將去表皮化的一段有如軟木塞一般的塞入傷口中，遠端的表皮可用來修補口內的缺損。此術式應用在二位病患身上，口腔皮膚瘻管均得以治癒。

並列摘要

Orocutaneous fistula is one of the major complications after oral cancer surgeries. Most of the patients with small fistula respond to conservative treatments. When conservative management fails, surgical repair is necessitated. We developed a novel method using medially-based deltopectoral flap to treat orocutaneous fistula. Two patients who underwent tumor excision followed by radiotherapy developed orocutaneous fistulae and were treated with the deltopectoral flap. The deltopectoral flap was elevated with deepithelialization of a segment of skin paddle. After tubing, the deepithelialized portion was inserted into the orocutaneous fistula as a plug. The distal part of the skin paddle was sutured to intraoral mucosa defect. Division of the deltopectoral flap was performed three weeks later. The orocutaneous fistula sealed successfully after the deltopectoral flap reconstruction.

並列關鍵字

orocutaneous fistula ； deltopectoral flap