头颈部重建游离皮瓣失败。

Head & Neck Pub Date : 2014-10-01 Epub Date: 2014-02-01 DOI:10.1002/hed.23471
Christian Corbitt, Roman J Skoracki, Peirong Yu, Matthew M Hanasono
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引用次数: 91

摘要

背景:本研究的目的是确定头颈部游离皮瓣丢失的原因,并评估随后微血管和非微血管重建的结果。方法:回顾性分析2000 ~ 2012年游离皮瓣丢失患者的临床资料。结果:3090个游离皮瓣中有40个皮瓣丢失(1.3%)。28例患者后续行游离皮瓣重建,27例成功(96.4%),与我们的初始皮瓣成功率无显著差异(p = .81)。在随后进行口腔/咽缺损自由皮瓣重建的患者中,100%的患者语音清晰度>80%,87.5%的患者不需要管饲。相比之下,42.9%接受胸大肌瓣重建的患者言语清晰(p = 0.01), 25.0%能够独立于管饲(p = 0.02)。结论:有选择的患者在游离皮瓣丢失后进行后续的游离皮瓣移植是成功的。与带蒂皮瓣重建相比,随后的自由皮瓣重建的功能结果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Free flap failure in head and neck reconstruction.

Background: The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction.

Methods: Patients who experienced free flap loss between 2000 and 2012 were reviewed.

Results: There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02).

Conclusion: Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.

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