复合下颌缺损重建中游离腓骨瓣供体腿和受体血管选择的比较分析

IF 2 3区 医学 Q2 SURGERY
Ching-En Chen , Chun-Yu Ma , Chin-Jung Feng , Tien-Hsiang Wang , Yu-Chung Shih , Chih-Hsun Lin , Szu-Hsien Wu , Fu-Yin Hsiao , Mei-Chun Chen , Hsu Ma , Cherng-Kang Perng
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引用次数: 0

摘要

背景游离腓骨瓣(FFF)被认为是重建复合下颌缺损(COMD)的首选,但供体腿选择的影响仍未得到充分探讨。本研究旨在探讨皮瓣失败与供体腿和受体血管侧的选择之间的相关性。材料和方法在2011年至2020年的回顾性分析中,我们使用电子记录检查了用于COMD的FFF。研究考虑了患者数据、合并症、放射史、FFF细节和术中变量。侧位分为 "顺式 "和 "反式 "两组,并根据供血情况进一步细分。分析包括逻辑回归、双变量分析和倾向评分匹配。结果 共纳入 155 例仅通过 FFF 皮瓣修复口内粘膜缺损的受试者。根据 COMD 侧和供体腿的选择,病例被分为 "顺式 "组(n = 65;42%)和 "反式 "组(n = 90;58%)。没有出现明显的基线差异。逻辑回归发现,侧位对 FFF 的总失败率没有影响。最初,性别与皮瓣失败有关联,但调整后关联性减弱。部分皮瓣坏死与糖尿病有关,与侧位无关。倾向评分匹配显示,左右腿在侧位或皮瓣总失败风险方面没有明显差异。亚组分析发现,"顺式 "组和 "反式 "组在参数或皮瓣失败率方面没有差异。此外,尽管血管吻合可能会因血管蒂长度或创伤史而受到限制,但受体血管侧的选择显然不会影响皮瓣失败。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A comparative analysis of free fibula flap donor leg and recipient vessel selection in composite oromandibular defect reconstructions

Background

The free fibula flap (FFF) is acknowledged as the primary choice for reconstructing composite oromandibular defects (COMDs), yet the impact of donor leg selection remains inadequately explored. This study aims to investigate the correlation between flap failure and the choice of donor leg and recipient vessel side.

Materials and methods

In a retrospective analysis spanning 2011 to 2020, FFFs for COMD were examined using electronic records. Patient data, comorbidities, radiation history, FFF details, and intraoperative variables were considered. Laterality was categorized into “Cis” and “Trans” groups, further subclassified based on blood supply. Analyses involved logistic regression, bivariate analysis, and propensity score matching.

Results

A total of 155 subjects with intraoral mucosal defects repaired only by the skin paddle of FFF were included. Cases were categorized into “Cis” (n = 65; 42%) and “Trans” (n = 90; 58%) groups based on COMD side and donor leg selection. No significant baseline differences emerged. Logistic regression found no laterality impact on total FFF failure. Initially, gender correlated with flap failure, but adjustment diminished the association. Partial skin paddle necrosis correlated with diabetes, not laterality. Propensity score matching revealed no significant differences between right and left legs in laterality or total flap failure risk. Subgroup analysis found no differences in parameters or flap failure rates within “Cis” and “Trans” groups.

Conclusion

Donor leg selection in COMD reconstruction with FFFs does not exhibit specificity. Furthermore, despite potential limitations in vessel anastomosis due to pedicle length or trauma history, recipient vessel side selection does not evidently affect flap failure.
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来源期刊
CiteScore
3.10
自引率
11.10%
发文量
578
审稿时长
3.5 months
期刊介绍: JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.
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