桡侧皮瓣:一种有价值的口腔内重建筋膜皮瓣。

Y Fujimoto, Y Hamamura, K Inoue, K Shirasuna, M Urade, M Sugiyama, M Kogo, Y Uchida, T Matsuya
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摘要

前臂桡侧皮瓣,又称前臂皮瓣,因其发展被中国医生称为“中国皮瓣”,最初是为矫正面部和颈部烧伤后的收缩而设计的。前臂桡侧皮瓣是筋膜皮瓣的一种,由桡动脉供应,作为一种单期显微外科重建转移。在口腔颌面部,重建主要采用三角肌瓣(D-P瓣)和大肌谱肌瓣(P-M-M-C瓣)。然而,这些皮瓣有时过于笨重,难以转移,更多的需要两阶段手术。另一方面,由于前臂皮瓣薄而柔韧,一些医生在单期自由皮瓣重建中使用该皮瓣进行显微外科手术。两年前,我们已经开始转移前臂桡侧皮瓣进行口腔内重建。操作方法如下。前臂桡侧皮瓣的设计与抬高用超声多普勒血流仪在皮肤上标记桡动脉和前臂皮下静脉。2. 皮瓣按重建模式设计大20%,以前臂桡动脉远端段为轴,包括前臂正中静脉。3.在手术之前,必须进行Allen试验,以确定手在没有桡动脉输入的情况下是否能存活。4. 手术是用手臂止血带进行的。皮瓣边缘向下切开至深筋膜,隔离并保留近端皮下静脉。(摘要删节250字)
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[Radial flap: a valuable fasciocutaneous flap for intra-oral reconstruction].

The radial forearm flap, or the forearm flap, is called "Chinese flap" for its development of the chinese doctors, and is originally designed for the correction to the post-burn contraction of the face and neck. The radial forearm flap is one of the fasciocutaneous flap, supplied by the radial artery, and transferred as a single-stage reconstruction micro-surgically. In oral and maxillofacial region, the deltopectral flap (D-P flap) and the pectralis major myocutaneous flap (P-M-M-C flap) are mainly used for the reconstruction. These flaps, however, are sometimes too bulky and limited to transfer, and more require two-stage operations. On the other hand, as the forearm flap being thin and pliable, some doctors use this flap micro-surgically at single-stage free flap reconstruction. Before two years, we have begun to transfer the radial forearm flap for the intra-oral reconstruction. The operation method is as follows. Design and Elevation of the Radial Forearm Flap 1. Using the ultrasonic doppler flow meter, the radial artery and the subcutaneous forearm veins are marked on the skin. 2. The flap is designed 20% larger according to the pattern to be reconstructed, with the distal section of the radial artery as an axis on the forearm and the median vein of forearm inclusively. 3. Before the operation, Allen test must be performed in order to determine whether the hand will survive without a radial arterial in-put. 4. The operation is performed with a arm tourniquet. The margin of the flap are incised down to the deep fascia, isolating and preserving the proximal subcutaneous veins as required.(ABSTRACT TRUNCATED AT 250 WORDS)

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