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Title: [Outcome of relaying anterolateral thigh perforator flap in resurfacing the donor site wound following free anteromedial thigh perforator flap transfer for reconstruction of defect after oral tumor radical resection].
Author: Song DJ, Li Z, Zhou X, Zhang YX, Peng XW, Zhou B, Lyu CL, Yang LC, Peng W.
Journal: Zhonghua Shao Shang Za Zhi; 2017 Feb 20; 33(2):72-76. PubMed ID: 28219139.
Abstract:
Objective: To observe the outcome of relaying anterolateral thigh (ALT) perforator flap in resurfacing the donor site wound following free anteromedial thigh (AMT) perforator flap transfer for reconstruction of defect after oral tumor radical resection. Methods: From January 2013 to January 2016, 28 patients with oral tumor underwent radical resection in our hospital, leaving defects with size ranged from 6.5 cm×3.5 cm to 11.0 cm×7.5 cm which were reconstructed by free AMT perforator flaps with size ranged from 7.0 cm×4.0 cm to 12.0 cm×8.0 cm. All the arteries of AMT perforators were anastomosed with superior thyroid arteries, while the venae comitants were anastomosed with superior thyroid venae or internal jugular venae. The donor site wounds of free AMT perforator flaps were reconstructed by relaying ALT perforator flaps with size ranged from 8.0 cm×3.5 cm to 14.0 cm×7.5 cm. The relaying ALT perforator flap and wound edge were closed directly with layer interrupted suture. Postoperatively, the patients stayed in bed and received diet through nasal feeding tube, and the ordinary diet and lower extremity exercise were carried out from one week after operation. Results: The AMT and ALT perforators existed consistently in all patients. In 16 patients the venae comitants of AMT perforator arteries were anastomosed with superior thyroid venae in end-to-end fashion, while in 12 patients with internal jugular venae in end-to-side fashion. All flaps survived uneventfully about 2 weeks after operation, and the wounds healed smoothly. All patients were followed up for 6 to 30 months after operation. The sites repaired with free AMT perforator flaps were not bulky in appearance, with two-point discrimination distances ranged from 8 to 15 mm. The movement of tongue was not obviously affected, and patients could speak and eat normally. The texture and color of the sites repaired with relaying ALT perforator flaps were close to those of the adjacent tissue, and the two-point discrimination distances of the sites repaired with relaying ALT perforator flaps were ranged from 7 to 12 mm. The function of thigh was not obviously affected, and patients could walk normally and do related daily activities. Conclusions: Reconstruction of defect after oral tumor radical resection with free AMT perforator flap can achieve good outcome, and wound in the donor site of free AMT perforator flap repaired with relaying ALT perforator flap can achieve good appearance and function recovery. 目的：观察游离股前内侧穿支皮瓣修复口腔肿瘤根治术后缺损并用接力股前外侧穿支皮瓣修复供区创面的效果。 方法： 2013年1月—2016年1月，笔者单位收治28例口腔肿瘤患者，行肿瘤根治术后形成6.5 cm×3.5 cm～11.0 cm×7.5 cm大小缺损，用面积为7.0 cm×4.0 cm～12.0 cm×8.0 cm游离股前内侧穿支皮瓣修复，术中将股前内侧穿支动脉与甲状腺上动脉吻合，将其伴行静脉与甲状腺上静脉或颈内静脉吻合。游离股前内侧穿支皮瓣供区创面采用面积为8.0 cm×3.5 cm～14.0 cm×7.5 cm接力股前外侧穿支皮瓣修复，将皮瓣与创缘拉拢后分层间断缝合。术后卧床休息并采用胃管鼻饲，术后1周开始正常进食并行下肢运动。 结果：所有患者股前内侧和外侧穿支恒定存在，股前内侧穿支动脉伴行静脉与甲状腺上静脉端端吻合16例、与颈内静脉端侧吻合12例。术后2周左右皮瓣全部顺利成活，创面愈合良好。术后随访6～30个月，游离股前内侧穿支皮瓣修复处外形不臃肿，两点辨别觉距离为8～15 mm，舌运动未见明显受限，对患者说话、进食无明显影响；接力股前外侧穿支皮瓣修复处质地和色泽与周围皮肤接近，两点辨别觉距离为7～12 mm，大腿功能未见明显影响，患者可正常行走及进行相关日常活动。 结论：游离股前内侧穿支皮瓣修复口腔肿瘤根治术后缺损效果较好，游离股前内侧穿支皮瓣供区创面经接力股前外侧穿支皮瓣修复后外观及功能恢复较佳。.

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