关键词: Deep circumflex iliac artery Iliac crest bone Island flap Mandibular reconstruction Patient monitoring

Mesh : Humans Male Pilot Projects Mandibular Reconstruction / methods Ilium / transplantation surgery blood supply Middle Aged Female Perforator Flap / blood supply Abdominal Muscles / diagnostic imaging surgery transplantation Iliac Artery / surgery diagnostic imaging Adult Treatment Outcome Aged Bone Transplantation / methods Mandibular Neoplasms / surgery diagnostic imaging

来  源:   DOI:10.1016/j.ijom.2023.12.007

Abstract:
The deep circumflex iliac artery (DCIA) flap is one of the bone flaps commonly used for mandibular reconstruction. Observation of the skin paddle and Doppler ultrasound are methods that are usually used to monitor DCIA flaps after mandibular reconstruction surgery. The aim of this study was to introduce a novel DCIA flap with a perforator-supported external oblique abdominal muscle (EOAM) island for postoperative flap monitoring. This study included five patients who underwent mandibular reconstruction using this modified technique. The DCIA flap and the EOAM island supplied by the ascending branch of the DCIA were harvested during the surgery. After mandibular reconstruction, the EOAM island was placed in the submandibular region to monitor the blood supply to the DCIA flap after surgery. The blood supply to the DCIA flap was monitored by observing the colour, texture, and bleeding condition of the EOAM island. After the monitoring period, the EOAM was removed and the ascending branch of the DCIA was ligated. The outcome was successful in all patients. The EOAM island supported by the ascending branch of the DCIA is reliable and safe, thus providing a robust option to monitor the blood supply to the DCIA flap.
摘要:
旋髂深动脉(DCIA)皮瓣是下颌骨重建常用的骨瓣之一。观察皮肤桨和多普勒超声是下颌骨重建手术后通常用于监测DCIA皮瓣的方法。这项研究的目的是介绍一种新型的DCIA皮瓣,该皮瓣具有穿支支撑的外斜腹肌(EOAM)岛,用于术后皮瓣监测。这项研究包括五名使用这种改良技术进行下颌骨重建的患者。DCIA皮瓣和由DCIA的上升分支提供的EOAM岛是在手术期间收获的。下颌骨重建后,将EOAM岛放置在下颌下区域,以监测手术后DCIA皮瓣的血液供应.通过观察颜色来监测DCIA皮瓣的血液供应,纹理,和EOAM岛的出血状况。监测期过后,移除EOAM,并连接DCIA的上升分支.结果在所有患者中都是成功的。由DCIA的上升分支支持的EOAM岛是可靠和安全的,因此提供了一个强大的选择来监测DCIA皮瓣的血液供应。
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