制备脊髓灰质炎下肢大腿前外侧皮瓣:一种安全的手术选择,可保留患者的运动功能。

IF 2.2 3区 医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-01-14 DOI:10.1016/j.jormas.2025.102233
Zi-Jie Yuan, Lei Chen, Xiao-Xia Cheng, Xing-Chi Liu, Liang Mao, Jing Li, Zi-Li Yu, Jun Jia
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引用次数: 0

摘要

股骨前外侧皮瓣是重建手术中常用的供体部位,尤其是头颈部重建。皮瓣的成功主要取决于其穿孔血管的质量和数量,这就是为什么临床医生通常更喜欢从血管解剖完整的健康腿上采集。脊髓灰质炎通常会引起单侧下肢瘫痪,导致肌肉萎缩和畸形。从瘫痪的腿上获取ALT皮瓣可以保留未受影响的肢体的功能,但这种方法由于受影响的腿上存在的萎缩和畸形而变得复杂,带来了巨大的挑战。我们在此报告一例55岁男性患脊髓灰质炎的患者,在舌部缺损的重建中成功获取ALT皮瓣。患者被诊断为左舌鳞状细胞癌,并接受舌癌切除和改良的根治性颈部清扫术。皮瓣存活下来,并与患者的舌头组织愈合良好。大腿供体部位的伤口也愈合得很好。皮瓣及供区均无并发症发生。我们的经验表明,从瘫痪的腿上摘取器官是一种安全可行的手术,可以保留未受影响肢体的功能,并可以提高脊髓灰质炎幸存者的术后生活质量。
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Preparation of anterolateral thigh flap from polio-affected lower limb: A safe surgical option that preserves patient's motor function.

The anterolateral thigh (ALT) flap is a commonly used donor site for reconstructive surger, especially in head and neck reconstructions. The flap's success is primarily determined by the quality and quantity of its perforating vessels, which is why clinicians typically prefer harvesting from a healthy leg with intact vascular anatomy. Poliomyelitis typically causes unilateral lower limb paralysis, resulting in muscle atrophy and deformities. Harvesting the ALT flap from the paralyzed leg could preserve the function of the unaffected limb, but this approach is complicated by the atrophy and deformities present in the affected leg, creating substantial challenges. We here report the successful ALT flap harvesting from the polio-affected leg in a 55-year-old male patient for the reconstruction of a tongue defect. The patient diagnosed with Left tongue squamous cell carcinoma, and underwent tongue cancer excision and a modified radical neck dissection. The flap survived and healed well with the patient's tongue tissue. The wound at the donor site on the thigh also healed well. There were no complications observed in either the flap or the donor site. Our experience suggests that harvesting from the paralyzed leg is a safe and feasible procedure that preserves the function of the unaffected limb and may enhance the postoperative quality of life for polio survivors.

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来源期刊
CiteScore
2.20
自引率
9.10%
发文量
305
期刊介绍: J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.
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