前臂皮瓣近心侧阶梯状切取双全厚皮片修复供区缺损的临床效果评价

doi:10.19438/j.cjoms.2026.02.010

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (2): 155-160.doi: 10.19438/j.cjoms.2026.02.010

前臂皮瓣近心侧阶梯状切取双全厚皮片修复供区缺损的临床效果评价

明华伟¹, 何芸², 袁宗毅¹, 张兴安¹, 贾佳欣¹, 陈方园¹, 刘子龙³, 谭小尧¹

1.首都医科大学附属北京安贞医院南充医院/南充市中心医院口腔颌面外科,四川南充 637000;
2.首都医科大学附属北京安贞医院南充医院/南充市中心医院口腔科,四川南充 637000;
3.川北医学院第二临床医学院,四川南充 637000

收稿日期:2025-05-14 修回日期:2025-08-05 出版日期:2026-03-20 发布日期:2026-04-02
通讯作者: 谭小尧,E-mail：txy92017@aliyun.com
作者简介:明华伟（1988—）,男,硕士,副主任医师,E-mail：huawei_wutong@126.com
基金资助:
四川省基层卫生事业发展研究中心课题（SWFZ20-C-081）;南充市科技局市校科技战略合作项目（20SXQT0261）

Evaluation of clinical effect of forearm flap with double thickness skin graft obtained by proximal cardiac step incision for repairing donor site defect

Ming Huawei¹, He Yun², Yuan Zongyi¹, Zhang Xing'an¹, Jia Jiaxin¹, Chen Fangyuan¹, Liu Zilong³, Tan Xiaoyao¹

1. Department of Oral and Maxillofacial Surgery, Nanchong 637000;
2. Department of Stomatology, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital. Nanchong 637000;
3. The Second Clinical Medical College of North Sichuan Medical College. Nanchong 637000, Sichuan Province, China

Received:2025-05-14 Revised:2025-08-05 Online:2026-03-20 Published:2026-04-02

摘要/Abstract

摘要： 目的: 探讨近心侧阶梯状切取双全厚皮片在前臂皮瓣供区创面修复中的可行性及临床效果。方法: 选取 2023年1月—2024年12月南充市中心医院口腔颌面外科12例口腔癌术后需同期行前臂皮瓣移植修复的患者,在制备前臂皮瓣时,于皮瓣近心侧采用阶梯形切口设计切取2个全厚皮片,体外拼接后移植修复供区缺损。术后随访3~6个月,评估供区愈合情况、并发症发生率及患者美学与功能满意度。结果: 12例患者均成功制备前臂皮瓣并切取双份全厚皮片,体外拼接后移植修复供区,11例供区实现一期愈合,前臂皮瓣全部成活。术后1例皮片因供区缝合张力过大发生坏死,经换药后瘢痕愈合;其余11例皮片完全成活,供区瘢痕细小,腕关节屈伸功能不受限,患者满意度较高。结论: 前臂皮瓣近心侧阶梯状切取全厚皮片拼接修复供区,可避免第三术区损伤,减少手术创伤,实现供区微创修复,是前臂皮瓣供区缺损修复的可行方案。

关键词: 前臂皮瓣, 供区修复, 口腔癌, 缺损修复, 全厚皮片

Abstract: PURPOSE: To investigate the feasibility and evaluate the clinical effect of double thickness skin graft obtained by proximal cardiac step incision in repairing the wound of forearm flap donor site. METHODS: From January 2023 to December 2024, 12 patients with oral cancer who required simultaneous forearm flap transplantation after surgery were enrolled in Nanchong Central Hospital. During flap preparation, two full-thickness skin grafts were harvested from the proximal side of the forearm flap using a stepped incision design. After in vitro splicing, the grafts were transplanted to repair the donor site defect. Postoperative follow-up lasted 3-6 months to evaluate donor site healing, complications, and patient satisfaction with aesthetics and function. RESULTS: All 12 patients successfully underwent forearm flap preparation, double full-thickness skin graft harvesting, and in vitro splicing. The donor sites of 11 cases achieved primary closure, and all forearm flaps survived. One skin graft developed necrosis due to excessive suture tension, which healed with scarring after dressing changes; the remaining 11 skin grafts survived completely, with small donor site scars, unimpaired wrist flexion-extension function, and high patient satisfaction. CONCLUSIONS: Stepwise harvesting of full-thickness skin grafts from the proximal forearm flap and splicing for donor site repair can avoid injury to the third surgical area, reduce surgical trauma, and achieve minimally invasive repair of the donor site. It is a feasible solution for the repair of donor site defects of the forearm flap.

Key words: Forearm flap, Donor site repair, Oral cancer, Defect repair, Full-thickness skin graft

中图分类号:

明华伟, 何芸, 袁宗毅, 张兴安, 贾佳欣, 陈方园, 刘子龙, 谭小尧. 前臂皮瓣近心侧阶梯状切取双全厚皮片修复供区缺损的临床效果评价[J]. 中国口腔颌面外科杂志, 2026, 24(2): 155-160.

Ming Huawei, He Yun, Yuan Zongyi, Zhang Xing'an, Jia Jiaxin, Chen Fangyuan, Liu Zilong, Tan Xiaoyao. Evaluation of clinical effect of forearm flap with double thickness skin graft obtained by proximal cardiac step incision for repairing donor site defect[J]. China J Oral Maxillofac Surg, 2026, 24(2): 155-160.

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前臂皮瓣近心侧阶梯状切取双全厚皮片修复供区缺损的临床效果评价

Evaluation of clinical effect of forearm flap with double thickness skin graft obtained by proximal cardiac step incision for repairing donor site defect

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