Full Thickness, Near-Total to Total Lower Lip Reconstruction Using Superficial Circumflex Iliac Artery Perforator Free Flap: A Case Report

IF 1.5 3区 医学 Q3 SURGERY Microsurgery Pub Date : 2024-10-03 DOI:10.1002/micr.31242
Edward A. Stanley, Vlad Illie
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Abstract

Near-total to total lower lip defects present significant challenges for reconstructive surgeons, requiring restoration of oral competency, maximization of oral aperture, and cosmetic appearance. This report explores a novel reconstructive option addressing all three needs. Traditionally, local flap options restore cosmesis and oral competency by recruiting local tissue of similar thickness, pliability, and appearance, but often result in microstomia. Conversely, free flaps prevent microstomia but can lead to bulky and cosmetically unacceptable reconstructions. We present the first case of using a super-thin superficial circumflex iliac artery perforator (SCIP) free flap for near-total, full-thickness lower lip reconstruction. The patient was a 66-year-old female with recurrent squamous cell carcinoma of the lower lip, requiring wide local excision and resulting in an 80% full-thickness defect with unilateral oral commissure loss. An 8 cm × 5 cm × 5 mm SCIP flap was raised with a 4.5-cm pedicle length and anastomosed to the facial artery and vein. Clear fluids were commenced 7 days postoperatively, wounds healed 2 weeks postoperatively, and a normal diet was resumed at this time. The SCIP flap offers an excellent additional option for managing full-thickness near-total to total lower lip defects. Its thin, pliable nature and minimal donor site morbidity help restore oral competency, maximize oral aperture, and achieve a pleasing cosmetic result.

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使用浅表环状髂动脉穿孔器游离皮瓣进行全厚、近全唇至全唇重建术:病例报告。
近全唇或全下唇缺损给整形外科医生带来了巨大的挑战,需要恢复口腔能力、最大限度地扩大口腔孔径和美容外观。本报告探讨了一种新型的重建方案,可满足上述三种需求。传统的局部皮瓣方案通过采集厚度、柔韧性和外观相似的局部组织来恢复外观和口腔功能,但往往会导致小口畸形。与此相反,游离皮瓣可以防止小口畸形,但可能导致重建后的皮瓣臃肿,外观上难以接受。我们介绍了第一例使用超薄髂周浅动脉穿孔带(SCIP)游离皮瓣进行近全口、全厚下唇重建的病例。患者是一名 66 岁的女性,下唇鳞状细胞癌复发,需要进行大范围局部切除,造成 80% 的全厚缺损,单侧口腔交界缺失。手术中制作了一个 8 厘米 × 5 厘米 × 5 毫米的 SCIP 皮瓣,蒂长 4.5 厘米,并与面部动静脉吻合。术后 7 天开始输清水,术后 2 周伤口愈合,此时恢复正常饮食。SCIP皮瓣为处理近全唇或全下唇全厚缺损提供了一个极佳的额外选择。其薄而柔韧的特性和最小的供体部位发病率有助于恢复口腔能力,最大限度地扩大口腔孔径,并达到令人愉悦的美容效果。
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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.
期刊最新文献
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