用于口周和鼻周肿瘤缺损重建的面动脉穿孔器皮瓣:手术技术和术后效果

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-09-17 DOI:10.1002/micr.31238
Pierre-Louis Chiche, François Avry, Julien Drouet, Pierre Weill, Hervé Bénateau, Quentin Qassemyar, Rachid Garmi
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引用次数: 0

摘要

引言 面部动脉穿孔器(FAP)皮瓣是一种多功能、可靠的一步式面部重建技术。然而,由于缺乏明确的指导原则和严格的技术要求,其潜力仍未得到充分发挥。本研究报告了本中心使用 FAP 皮瓣治疗口周和鼻部肿瘤缺损的情况,重点介绍了手术技巧和术后管理。 方法 我们对 4 年内所有在肿瘤切除后仅使用口周或鼻周 FAP 皮瓣进行重建的患者(29 人)进行了回顾性研究。测量参数包括皮瓣存活率、并发症发生率、手术技巧以及是否需要进行修补手术。根据患者的年龄、缺损大小和部位进行分组,并对各组的结果进行比较。 结果 组织学肿瘤缺损的平均面积为 331 平方毫米。在至少 6 个月的随访期间,未发现局部复发。27个(93.1%)皮瓣完全存活。7例(23.8%)患者出现了主要的术后并发症,包括皮瓣完全坏死(1例)、皮瓣部分坏死(1例)、皮瓣塌陷(1例)、静脉充血(1例)、伤口裂开(1例)和局部感染(2例)。鼻尖缺损的并发症发生率更高(80.0% 对 12.5%,P = 0.007)。涉及鼻侧壁和鼻背的重建更经常需要修整手术(53.8% 对 13.3%,P = 0.04)。 结论 根据我们的经验,FAP 皮瓣对重建上唇、鼻唇沟和某些肿瘤性鼻缺损非常有效。然而,鼻尖等特定的缺损位置可能与较高的并发症发生率有关,因此需要谨慎选择患者和制定手术计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Facial Artery Perforator Flap for Perioral and Perinasal Oncologic Defect Reconstruction: Surgical Technique and Postoperative Outcomes

Introduction

Facial artery perforator (FAP) flap is a versatile and reliable one-step facial reconstruction technique. However, its full potential remains underutilized due to a lack of clear guidelines and rigorous technique requirements. This study report the use of FAP flaps in our centre for the management of perioral and nasal oncologic defects, focusing on surgical technique performed and post-operative management.

Methods

We conducted a retrospective review of all patients who underwent reconstruction with a perioral or perinasal FAP flap only following tumor resection over a 4-year period (n = 29). Parameters measured included flap survival, complication rates, surgical technique performed, and the need for touch-up procedures. Patients were grouped based on age, defect size, and location and outcomes were compared across these groups.

Results

The mean histological tumor defect area was 331 mm2. During at least 6 months of follow-up, no local recurrence was observed. Twenty-seven (93.1%) flaps survived completely. Major postsurgical complications occurred in seven (23.8%) patients, including complete flap necrosis (1), partial flap necrosis (1), flap collapse (1), venous congestion (1), wound dehiscence (1), and local infection (2). A higher complication rate was associated with nose tip defects (80.0% vs. 12.5%, p = 0.007). Touch-up procedures were more frequently required for reconstructions involving the nasal sidewall and dorsum (53.8% vs. 13.3%, p = 0.04).

Conclusion

Based on our experience, the FAP flap is highly effective for the reconstruction of the upper lip, nasolabial fold, and certain oncologic nasal defects. However, specific defect locations, such as the nose tip, may be associated with higher complication rates, necessitating careful patient selection and surgical planning.

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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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