Open Versus Closed Suction Drainage in the Anterolateral Thigh Flap Reconstruction after Head and Neck Cancer Ablation

開放式引流及密閉式抽吸引流在頭頸部癌術後使用大腿前外側皮瓣重建之比較

洪國書(Kuo-Shu Hung) ； 陳思翰(Szu-Han Chen) ； 蕭振仁(Jenn-Ren Hsiao) ； 李曜洲(Yao-Chou Lee)

《臺灣整形外科醫學會雜誌》 25卷4期 (2016/12) Pp. 287-295

摘要

Background: Placement of open or closed suction drains in the free anterolateral thigh (ALT) flap reconstruction after head and neck cancer ablation has not yet been studied. We aim to clarify its impact on clinical outcomes. Materials and Methods: We conducted a retrospective cohort study to enroll the patients with head and neck cancer who had undergone ablative surgery and immediate ALT-only flap reconstruction in National Cheng Kung University Hospital between January 2013 and August 2014. Results: A total of 116 patients were included. The open drainage group contained 76 patients (65.5%) and the closed suction drainage group contained 40 (34.5%). The closed suction drainage group had comparable results with the open drainage group except a higher rate of fistula formation. Conclusions: Both open and closed suction drains are safe if they are carefully positioned.

關鍵字

drain ； ALT flap ； head and neck cancer

並列摘要

背 景：開放式引流管或密閉式抽吸引流管各有其優缺點；在頭頸部癌術後使用大腿前外側皮瓣進行重建手術的病人，使用開放式引流管或密閉式抽吸引流管目前並無定論。目的及目標：我們旨在探討不同種類的引流管對於頭頸部癌術後立即使用大腿前外側皮瓣進行重建手術的病人臨床結果的影響。材料及方法：我們利用回溯性的世代研究，統計從2013 年1 月到2014 年8 月在成功大學醫學院附設醫院因為口腔癌接受腫瘤切除手術及單純使用大腿前外側自由皮瓣進行立即重建的病患。結 果：總共有116 名患者被納入研究統計，開放式引流管的族群有76 位患者（佔65.5%），密閉式抽吸引流管則有40 位患者（佔34.5%）。兩個族群比較起來，密閉式抽吸引流管族群除了有較高的比例產生廔管之外，其他的臨床結果都沒有差異。結 論：如果置放得宜，兩種引流管都是安全的。