Salvage of an Unstable Facial Wound with a Reversed Pedicled Radial Forearm Flap-A Case Report

一位六十一歲男性口腔癌病患施行右頰部腫瘤廣泛切除、上顎骨及下顎骨的部份切除、及右側頸部淋巴腺廓清手術後，造成右頰部軟組織全層缺損、上顎骨、及下顎骨的部份缺損。重建的方式是先以裂層植皮隔開鼻道，再以右側前臂橈側游離皮瓣修補口腔黏膜缺損，下顎骨的缺損以肋骨架接，並以右側胸大肌島狀皮瓣重建右頰部皮膚及軟組織缺損。由於胸大肌島狀皮瓣意外地壞死，壞死皮瓣清除後在臉部形成輪廓的缺損及肋骨的暴露。由於病患過去曾經施行過左側頸部淋巴腺廓清術，在沒有適當的頸部血管可供吻合另一塊游離皮瓣，以及傷口即將感染的考量下，我們使用左前臂橈側逆流根蒂皮瓣覆蓋傷口。十六天後分割皮瓣，成功地補救了這皮瓣失敗所引起的困難傷口。

關鍵字

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並列摘要

A 61-year-old male underwent wide excision of a right buccal cancer, himimandibulectomy, extended maxillectomy, and modified radical neck dissection, which resuletd in a large complex defect of the maxilla, infratemporal fossa, hard palate, soft palate, lateral pharyngeal wall, mandible, and through and through defect of the buccal soft tissue. The defect was reconstructed by a free right radial forearm flap intraorally and an island myocutaneous flap of the pectoralis major muscle for outer lining. The mandibular defect was reconstructed with a rib graft, sandwiched by the forearm flap and pectoralis major myocutaneous flap. Unfortunately, the pectoralis major myocutaneous flap failed and resulted in a large complex facial defect as an emergency. Because of the prior bilateral modified radical neck dissection and impending infection of the wound, there were no adequate vessels for a further free flap. We used a reversed pedicled forearm flap to cover the defect and salvaged the difficult wound successfully.

並列關鍵字

buccal cancer ； extendes resection ； free flap failure ； reversed pedicled forearm flap for the salvage

國際替代計量

Salvage of an Unstable Facial Wound with a Reversed Pedicled Radial Forearm Flap-A Case Report

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