拱顶石皮瓣在颌面部软组织缺损修复中的应用：8例报道

doi:10.19438/j.cjoms.2021.05.014

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (5): 460-463.doi: 10.19438/j.cjoms.2021.05.014

拱顶石皮瓣在颌面部软组织缺损修复中的应用：8例报道

王祎, 陈传俊, 项先旺

中国科学技术大学附属第一医院口腔医学中心,安徽合肥 230001

收稿日期:2021-03-01 修回日期:2021-05-25 出版日期:2021-09-20 发布日期:2021-10-20
通讯作者: 陈传俊,E-mail：ccj6318@sina.com
作者简介:王祎（1977-）,男,博士,主治医师,E-mail:wlanyier@sina.com
基金资助:
中央高校基本科研业务费专项基金（WK9110000146）

Application of keystone flap in the reconstruction of maxillofacial soft tissue defect：report of 8 consecutive cases

WANG Yi, CHEN Chuan-jun, XIANG Xian-wang

Centre of Stomatology, First Affiliated Hospital of University of Science and Technology of China. Hefei 230001, Anhui Province, China

Received:2021-03-01 Revised:2021-05-25 Online:2021-09-20 Published:2021-10-20

摘要/Abstract

摘要： 目的探讨拱顶石皮瓣在修复颌面部各类软组织缺损中的应用效果。方法选择2019年1月—2020年6月行颌面部肿瘤切除的患者8例,设计拱顶石皮瓣,修复患者颌面部软组织缺损。缺损面积4 cm×3 cm~15 cm×8 cm;术中根据缺损部位不同,灵活设计拱顶石皮瓣的位置及形态,尽量保持与邻近知名动脉长轴一致,保证皮瓣中心1/3与基底软组织的连接,其余皮瓣与基底软组织做适当分离,使皮瓣获得更大游离度和旋转度。结果本组皮瓣均一期成活。术后随访发现,皮瓣色泽和形态良好;无感染、坏死,未见明显瘢痕挛缩,患者均能接受;面部功能无明显障碍。结论拱顶石穿支岛状皮瓣设计简单,血供丰富,安全有效,能够满足颌面部多种软组织中小型缺损的修复,值得在口腔颌面外科临床推广应用。

关键词: 拱顶石皮瓣, 穿支, 颌面软组织缺损, 重建

Abstract: PURPOSE: To evaluate the effect of keystone flap in reconstruction of maxillofacial soft tissue defects. METHODS: From January 2019 to June 2020, 8 patients with maxillofacial defects after tumor resection were selected, and keystone flap was designed to reconstruct maxillofacial soft tissue defects. The wound areas ranged from 4 cm×3 cm~15 cm×8 cm; the position and shape of the keystone flap were designed flexibly according to the different defect sites during operation, and the long axis of the keystone flap was consistent with that of the adjacent well-known arteries as far as possible. The central 1/3 of the flap was connected to the base of soft tissue, and the remaining portion of the flap could be properly separated from the base of soft tissue, so that the flap could obtain greater freeness and rotation. RESULTS: All flaps survived and healed primarily in this group.The color and shape of the skin flap recovered well during follow-up from 1 to 6 months. No infection, necrosis and obvious scar contracture were observed, which was acceptable to all patients. No significant impairment of facial function was observed. CONCLUSIONS: Keystone flap rich blood supply, decreased morbidity and effective outcomes, simple to be designed and can satisfy the reconstruction of various minor and medium soft tissue defects in maxillofacial area, which is worthy of clinical application.

Key words: Keystone flap, Perforator, Maxillofacial soft tissue defect, Reconstruction

中图分类号:

R782.2

王祎, 陈传俊, 项先旺. 拱顶石皮瓣在颌面部软组织缺损修复中的应用：8例报道[J]. 中国口腔颌面外科杂志, 2021, 19(5): 460-463.

WANG Yi, CHEN Chuan-jun, XIANG Xian-wang. Application of keystone flap in the reconstruction of maxillofacial soft tissue defect：report of 8 consecutive cases[J]. China J Oral Maxillofac Surg, 2021, 19(5): 460-463.

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拱顶石皮瓣在颌面部软组织缺损修复中的应用：8例报道

Application of keystone flap in the reconstruction of maxillofacial soft tissue defect：report of 8 consecutive cases

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