中国口腔颌面外科杂志 ›› 2019, Vol. 17 ›› Issue (4): 349-351.doi: 10.19438/j.cjoms.2019.04.014

• 论著 • 上一篇    下一篇

前臂Kiss皮瓣设计及其应用价值探讨

陈传俊, 王祎, 王来平, 周瑜, 朱伟政, 彭晖, 项先旺, 章礼玉   

  1. 中国科技大学附属第一医院 口腔颌面外科,安徽 合肥 230001
  • 收稿日期:2019-03-20 修回日期:2019-05-15 出版日期:2019-07-20 发布日期:2019-08-12
  • 通讯作者: 陈传俊,Email:ccj6318@sina.com
  • 作者简介:陈传俊(1963-),男,博士、教授,主任医师

Kiss flap design of radial forearm flap for primary closure of donor-site without skin-grafting

CHEN Chuan-jun, WANG Yi, WANG Lai-ping, ZHOU Yu, ZHU Wei-zheng, PENG Hui, XIANG Xian-wang, ZHANG Li-yu   

  1. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of USTC. Hefei 230001, Anhui Province,China
  • Received:2019-03-20 Revised:2019-05-15 Online:2019-07-20 Published:2019-08-12

摘要: 目的 对传统前臂皮瓣制备实施改进,寻求符合几何原则的供区直接关闭而免于植皮的制备方法。方法 13例口腔癌原发灶切除后,前臂皮瓣同期修复重建。皮瓣外形设计为展翼式2个亚单位Kiss皮瓣,两亚单位长轴相交呈V字形,皮瓣切取后周边存留组织形成V-Y几何形态。Kiss皮瓣亚单位的长度和宽度根据受区面积大小做适当调整。皮瓣切取后将两个亚单位拼接,经血管吻合移植重建口腔肿瘤切除后的创面,供区按V-Y成形直接拉拢缝合关闭。结果 前臂Kiss皮瓣两个亚单位经拼接后的面积可以达到传统前臂皮瓣制备的面积;皮瓣供区均能一期关闭而无需植皮;2个亚单位均能获得独立血供而成活。结论 前臂2个亚单位Kiss皮瓣设计,V-Y成形直接关闭供区而无需植皮,避免了取皮创伤和植皮区的瘢痕形成,提高了美学效果,值得推广应用。

关键词: 前臂皮瓣, Kiss皮瓣, 皮瓣设计, V-Y成形, 供区关闭

Abstract: PURPOSE: The design and harvest of radial forearm (RF) flap was modified with kiss flap technique in order to achieve the aim that skin-graft in donor site was not necessarily performed. Methods: The shape of RF flap was designed as two components of kiss flaps like flying wings. The long axis of the two components formed a V shape, and the surrounding retained tissues formed a V-Y geometry after the flap was harvested.The length and width of the components can be adjusted according to the size of the defects.Side-to-side stitching of the two components formed the final surface area to match recipient site and reconstruct the defect and the donor site was directly closed based on V-Y plasty. Results: Reassembling of the two components of RF kiss flap reached the same area of traditional radial forearm flap and the components survived well based on the cutaneous perforator vessels. The donor-site was directly closed without skin-grafting. Conclusions: Kiss design of RF is an ideal technique as donor-site can be directly closed with less donor-site morbidities,less scar formation and no skin-grafting.

Key words: Radial forearm free flap, Kiss flap, Design of flap, V-Y plasty, Donor site closure

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