- 期刊
Suction Lipectomy with Nonstandard Open-tip Cannula and W-plasty for Flap Contouring Running Head: Liposuction and W-plasty for Flap Debulking
利用W-整形術及非傳統抽脂方法來重塑自由皮瓣之外觀
摘要
利用自由皮辦來修補口腔癌術後的缺損是重建手術的主要方法，然而太厚的外觀及明顯的疤痕常常需要二次以上的減厚手術來改善其外觀及功能，其中抽脂是較常使用的方法。傳統的抽脂是用鈍頭管套來施行，但是皮瓣的皮下組織相對來說其質地較密實，所以不能有效的抽出皮下脂肪，效果不甚理想，對這個問題，我們因此改用前端有開口的管套來抽脂。 高雄醫學大學附設醫院整形外科自2001年1月至2005年1月共有204位口腔癌患者接受廣泛性切除手術及自由皮瓣修補，其中有52例(25%)因外觀問題接受了以下的手術，利用口徑為10公釐及8公釐前端有開口的管套，來做抽脂手術以重塑皮瓣外觀，同時用W-整形術來修飾皮瓣周圍的疤痕，結果得到很好的成效。所有皮瓣都沒有因此而有部分或全部壞死，而且一次手術可以解決外觀問題，並令患者感到滿意。它的優點是方法簡單且沒有併發症。
關鍵字
無資料並列摘要
To manage oral defect following ablative cancer surgery the microvascular free tissue transfer is in fashion, and the bulkiness of such flaps usually poses concerns to both patients and surgeons after the operation, therefore, debulking procedures are usually in order. The suction lipectomy is the more common procedure than the other debulking procedures. Standard suction lipectomy procedure is usually using a small blunt-tip cannula, which can not adequately suck out the subdermal fat, due to the flap is relatively dense and compact in consistency. To resolve the inadequacy of this standard suction lipectomy procedure, we introduce the use of nonstandard open-tip cannula. In this study, we generated 204 patients, ranging in age from 35 to 69 years old, who underwent ablative surgery for oral squamous cell carcinoma from January 2001 to January 2005. All 204 patients had through-and-through oral defects and accepted free tissue transfer, however, because of the unsightly bulky appearance, 52 (25%) of them received a combination of both liposuction by open-tipped cannula and scar revision by w-plasty. We reported that the use of nonstandard open-tip cannula 10 mm or 8 mm in diameter for debulking lipectomy produced excellent cosmetic results with our patients in this study. We combined this technique with W-plasty scar revision at the same time. There is no partial or total flap necrosis noted in this one-stage operation and all patients were satisfied with the outcome.