使用微创方法采集的游离乳内动脉穿孔器皮瓣进行面部重建:两个病例的报告。

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-09-03 DOI:10.1002/micr.31233
Yun Choi, Kyeong-Tae Lee
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引用次数: 0

摘要

乳内动脉穿孔器(IMAP)皮瓣已被广泛用于胸壁和颈部重建。它的皮瓣颜色与面部皮肤非常相似,因此在面部重建中很有吸引力。然而,关于游离 IMAP 皮瓣使用情况的调查报告并不充分。此外,即使在这些研究中,也采用了一些侵入性程序,包括肋软骨切除,以确保足够的蒂长度,这可能会增加供体的发病率。我们的报告介绍了两例成功使用游离IMAP皮瓣进行面部缺损重建的病例,对供体部位的损伤极小,显示了其可行性。在第一个病例中,一名 48 岁的男性因右颊恶性黑色素瘤接受了广泛切除术,导致 4 × 4.5 厘米的全厚缺损。在不切除肋软骨、保留 IMA 主干的情况下,移植了一个带有 2.5 厘米蒂的游离 IMAP 皮瓣,并与缺损处的角血管吻合。第二位患者的左脸颊上有一个 4.5 × 3.5 厘米的基底细胞癌,需要进行广泛切除,并留下一个 6 × 5 厘米的缺损。患者采用同样的方法采集了一个游离的 IMAP 皮瓣,并利用血管桥成功地重建了与颞浅血管相连的缺损。两名患者出院时均无并发症,分别在 24 个月和 15 个月的随访中未见复发。他们对最终的皮肤颜色和质地效果非常满意。在最大程度降低供体发病率的同时,采集游离 IMAP 皮瓣可为面部重建提供一个极具吸引力的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Free Internal Mammary Artery Perforator Flap Harvested With Minimally Invasive Approach for Facial Reconstruction: Report of Two Cases

The internal mammary artery perforator (IMAP) flap has been widely used for chest wall and neck reconstruction. The color of its skin paddle closely resembles that of facial skin, making it attractive for facial reconstruction. However, there has been insufficient investigations reporting the use of free IMAP flap. Furthermore, even in such studies, somewhat invasive procedures, including rib cartilage resection, were employed to ensure sufficient pedicle length, potentially increasing donor morbidity. Our report presents two cases of successful facial defect reconstruction using a free IMAP flap harvested with minimal donor site damage, showing its feasibility. In the first case, a 48-year-old male underwent wide excision for a malignant melanoma on his right cheek, resulting in a 4 × 4.5 cm full-thickness defect. A free IMAP flap with a 2.5 cm pedicle, was harvested without rib cartilage resection, preserving IMA main trunk, and transferred with anastomosed to the angular vessels within the defect. The second patient presented with a 4.5 × 3.5 cm basal cell carcinoma on the left cheek, necessitating wide excision and leaving a 6 × 5 cm defect. A free IMAP flap was harvested with the same approach and successfully reconstructed the defect with connected to the superficial temporal vessels using vascular bridge. Both patients were discharged complication-free, with no recurrence during 24 and 15 months of follow-up, respectively. They were highly satisfied with the final skin color and texture outcomes. Harvesting a free IMAP flap while minimizing donor morbidity may offer an attractive option for facial reconstruction.

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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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