下唇游离皮瓣重建术:系统回顾与元分析》。

IF 2.2 3区 医学 Q2 SURGERY Journal of reconstructive microsurgery Pub Date : 2024-07-24 DOI:10.1055/s-0044-1788543
Alexander Murray-Douglass, Pascalino Romeo, Carly Fox
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引用次数: 0

摘要

背景:下唇大面积缺损通常需要游离组织覆盖。筋膜皮游离瓣是传统的使用方法,但神经支配的肌肉游离瓣可从根本上解决口轮匝肌缺损问题,并提高动态能力。本综述旨在确定在重建下唇50%以上的缺损时,神经支配肌肉游离皮瓣是否比筋膜游离皮瓣更有优势。相关结果包括口腔功能结果(包括口腔能力)、美学结果和患者报告的结果测量:在五个数据库(PubMed、Embase、Web of Science、CINAHL 和 CENTRAL)中搜索 "唇 "和 "游离皮瓣 "的变体。两位作者对文章进行了筛选,并收录了对任何病因引起的活人下唇50%以上的游离皮瓣重建的主要研究,并提供了英文全文。复合骨瓣除外。研究提取了口腔能力和美学满意度、重建细节和并发症。使用比例荟萃分析来综合筋膜游离皮瓣的结果,并与肌肉游离皮瓣的结果进行比较:结果:共纳入59篇文章,描述了242名患者。肌肉游离皮瓣的口腔功能比例明显高于筋膜游离皮瓣(98% vs. 83%,p = 0.01)。筋膜皮瓣和肌肉游离瓣的美学效果(98% 对 97%,p = 0.22)和并发症(17% 对 18%,p = 0.79)相当:肌肉游离皮瓣可解决导致口腔功能不全的基本眼轮匝肌缺损问题,似乎可提供更好的功能效果。结论:肌性游离皮瓣可从根本上解决导致口轮匝肌缺损的口腔功能不全问题,似乎可提供更好的功能效果,其美学效果和并发症似乎也相当。
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Free Flap Reconstruction of the Lower Lip: A Systematic Review and Meta-Analysis.

Background:  Large defects of the lower lip often require free tissue coverage. Fasciocutaneous free flaps have been traditionally used, but innervated muscular free flaps may fundamentally address orbicularis oris deficiency and improve dynamic competence. This review aimed to determine if innervated muscular free flaps provided benefit over fasciocutaneous free flaps for reconstruction of defects of more than 50% of the lower lip. Outcomes of interest included functional oral outcomes including oral competence, aesthetic outcomes, and patient-reported outcome measures.

Methods:  Five databases (PubMed, Embase, Web of Science, CINAHL, and CENTRAL) were searched for variations of "lip" and "free flap." Two authors screened articles and included primary research of free flap reconstruction of more than 50% of the lower lip from any etiology in living humans with an English full-text available. Composite bony flaps were excluded. Oral competence and aesthetic satisfaction, reconstruction details, and complications were extracted. Proportional meta-analyses were used to synthesize results for fasciocutaneous free flaps, which were compared with those for muscular free flaps.

Results:  Fifty-nine articles describing 242 patients were included. Muscular free flaps reported significantly higher proportional oral competence than fasciocutaneous free flaps (98 vs. 83%, p = 0.01). Aesthetic outcomes (98 vs. 97%, p = 0.22) and complications (17 vs. 18%, p = 0.79) were equivalent between fasciocutaneous and muscular free flaps.

Conclusion:  Muscular free flaps may address the fundamental orbicularis oris defect that causes oral incompetence and seem to provide better functional results. Aesthetic outcomes and complications seem to be equivalent.

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来源期刊
CiteScore
4.50
自引率
28.60%
发文量
80
审稿时长
1 months
期刊介绍: The Journal of Reconstructive Microsurgery is a peer-reviewed, indexed journal that provides an international forum for the publication of articles focusing on reconstructive microsurgery and complex reconstructive surgery. The journal was originally established in 1984 for the microsurgical community to publish and share academic papers. The Journal of Reconstructive Microsurgery provides the latest in original research spanning basic laboratory, translational, and clinical investigations. Review papers cover current topics in complex reconstruction and microsurgery. In addition, special sections discuss new technologies, innovations, materials, and significant problem cases. The journal welcomes controversial topics, editorial comments, book reviews, and letters to the Editor, in order to complete the balanced spectrum of information available in the Journal of Reconstructive Microsurgery. All articles undergo stringent peer review by international experts in the specialty.
期刊最新文献
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