关键词: 前臂游离皮瓣, 对偶三角瓣, 原位小面积全厚皮片

Abstract: PURPOSE: To introduce a method of repairing donor site defect after forearm free flap harvest with dual triangular flaps combined with in situ small full thickness skin flaps. METHODS: Free forearm skin flaps were applied for repairing defects after tumor resection in 25 patients with oral squamous cell carcinoma. In order to repair the donor site defect in situ, the dual triangular flaps and adjacent full-thickness skin flaps were designed and fabricated while the forearm free flaps were prepared. RESULTS: Twenty-five cases with forearm donor site defects were successfully repaired with dual triangular flaps combined with in situ small full thickness skin grafts. All the adjacent full-thickness skin grafts used to close the donor site defect of forearm survived, and the wound healed well without delayed wound rupture and serious complications. The movement of elbow and wrist joint on the side of the flap was normal, blood supply in the palm was normal, and the skin color of the donor site of the forearm skin flap was similar to the surrounding tissue. There was no deficiency or contracture deformity. Moreover, compared with the abdominal skin grafting group, there was no significant difference in swelling and wrist movement between the forearm adjacent skin grafting group and the abdominal skin grafting group, but the former technique reduced the risk of scar infection and tendon exposure, and greatly improved the aesthetics of the donor site. CONCLUSIONS: Modified donor dual triangular flaps combined with adjacent full thickness skin graft can reduce the recovery time during and after operation and avoid the trauma in the third operation area. It is worthy of practical application in the preparation of forearm skin flaps in oral and maxillofacial surgery.

Key words: Free forearm flap, Dual triangular flaps, Small in situ skin flaps