L-Extension Deltopectoral Flap in Head and Neck Reconstruction

口腔癌的病患經由根除性手術切除病灶區，其重建手術在美觀之要求及功能的恢復上，往往十分困難。肩胸皮瓣是由表皮、皮下組織以及筋膜所組成的；肩胸皮瓣的血流供應主要是來自內乳動脈之穿通枝，特別是第二及第三穿通枝，而且靜脈迴流系統是相當可靠。肩胸皮瓣之三角肌區通常並無毛髮附著，所以容易藉由衣著來覆蓋手術後缺損區，因此肩胸皮瓣是容易被病人接受的。在報告的分析上，我們提出十個病例，是採用L延伸型肩胸皮瓣的手術來修補頭頸部的缺損，而且並無預先延遲性的手術步驟，重建的區域包括頰部、口底、唇部、上腭部以及上顎眼眶區域，其中一例因為皮瓣壞死，而需要利用前臂皮瓣來做第二次的修補；另外二例有小部份的壞死，在傷口清創之後，復原情況很好。根據此份報告的顯，利用L延伸型肩胸皮瓣的設計，乃是一種可靠且多樣性的方法，可用來重建頭頸部的缺損。

關鍵字

肩胸皮瓣；口腔癌

並列摘要

With more radical ablation for oral cancer, increasing difficulty was encounted in surgical reconstruction of the defect for good aesthetic appearance and function. The deltopectoral flap is a fasciocutaneous flap that is composed of fascia, subcutaneous tissue, and skin. Its blood supply is from the perforating branches of the internal mammary artery, especially the 2nd and 3rd perforators, and the venous drainage is reliable. The deltoid portion of the deltopectoral flap is usually not hair-bearing and the donor site can be concealed by clothing. In this analysis, we reported 10 cases of oral cancer using an L-extension deltopectoral flap technique for repairing the surgical defects without prior delayed procedure. The sites of reconstruction included cheek, mouth floor, lips, palate, and orbitomaxillary area. Only one flap was necessary to repair with forearm flap in second stage. Two minor complications were seen and healed after wound debridement. According to the analysis, we recommend the L-extension deltopectoral flap to be a reliable and versatile technique for head and neck reconstruction.

並列關鍵字

Deltopectoral flap ； Oral cancer

國際替代計量

L-Extension Deltopectoral Flap in Head and Neck Reconstruction

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