- 期刊
Anterolateral Thigh Flap with Vastus Lateralis Muscle for Head and Neck Reconstruction
使用自由前外側股皮瓣併股外側肌用於頭頸部重建
摘要
自由前外側股皮瓣併股外側肌用於頭頸部重建，優點在於有廣泛用途，並可結合其他組織來重建複雜性缺損。頭頸部腫瘤切除後之大範圍缺損，對於單次手術，使用單一皮瓣來重建是比較困難的。使用自由前外側股複合皮瓣，可較容易達成重建目的。在1999年間，一共有九位患者使用此皮瓣，用於頭頸部重建。結果發現，間隔皮穿支血管佔22.2%。二至三條股皮穿支血管（平均2.56個）包含在股外側肌裡。遠端的肌皮穿支血管，位於中三分之一至下三分之一股外側肌交界處。血管莖分離至外旋股動脈主幹處，可以得到較大之血管與單一動靜脈用於吻合血管，術後除一皮瓣發生靜脈栓塞，經靜脈重新吻合外，所有皮瓣均完全存活。使用前外側股皮瓣併股外側肌用於頭頸部重建，優點包括了可避免因解剖學變異導致的皮穿支血管分離的危險，使表皮血與肌肉血流更加豐富與安全，並可填塞死腔防止感染，所以此皮瓣在大範圍缺損的頭頸部重建，是個良好的選擇。
關鍵字
無資料並列摘要
Part of large defects after tumor ablation in the head and neck area are difficult to replace in one stage with a single flap. For the large defects, the combined anterolateral thigh flap with the vastus lateralis muscle could achieve the goal of the one-staged reconstruction with a single flap. We used the anterolateral thigh flap with the vastus lateralis muscle in 9 cases of the head and neck reconstruction in 1999. The septocutaneous perforators were found in 2 of 9 cases (22.2%). Two to three musculocutaneous perforators (average numbers 2.56) were noted passing through the vastus lateralis muscle. The distal musculocutaneous perforators were located mainly at the area between the middle third and distal third of the vastus lateralis muscle. The vascular pedicles were dissected to the main trunk of the lateral femoral circumflex artery for the maximal pedicle length. Besides, one artery with one concomitant vein could be obtained for the microvascular anastomosis. One flap developed venous thrombosis and complete survival was achieved following the successful salvage by the venous reanastomosis. All flaps survived completely. The use of the anterolateral thigh flap with the vastus lateralis muscle has the advantages of avoiding the risk of dissecting the cutaneous perforators, secure vascularity of the cutaneous and muscular portion, and enough volume for obliterating the dead space. The combined anterolateral thigh flap is particularly useful for the extensive defects in the head and neck reconstruction.
延伸閱讀
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