PDF(Pubmed)
Abstract：
Introduction: Pectoralis major myo-cutaneous (PMMC) flap continues to be a widely used tool to reconstruct oral cavity defects. But an unreliable and unstable vascular supply can lead to complications like flap loss, Oro-cutaneous fistula and wound dehiscence. Preservation of the lateral thoracic artery (LTA) has been suggested to improve the vascularity of the skin paddle. The present study aspires to compare the complications and flap related outcomes after preserving or sacrificing the LTA while reconstructing oral cavity defects with bi-folded PMMC flap. Materials and Methods: Retrospective analysis of the data of 61 male patients who were reconstructed with bi-folded PMMC flaps between January 2022 and September 2022 was done. 36 patients were reconstructed using a PMMC flap where the LTA was sacrificed, whereas in 25 patients the LTA was preserved. Data was analyzed in terms of patient factors and flap related complications. Results: The overall complication rate including major/minor complications was 44.26% with flap detachment at 22.95% being the commonest complication observed. 13.11% patients developed an Oro-cutaneous fistula and partial and complete flap loss were seen in 9.83% and 4.91% respectively. LTA preservation was significantly associated with only decreased flap detachment rates (p value < 0.05). No significant association was noticed between other flap related complications and LTA preservation. Conclusion: Reconstructing larger defects with a PMMC flap where the LTA is preserved can help improve the vascularity of the flap and decrease various major/minor flap related complications.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04123-3.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04123-3.
摘要：
简介：胸大肌肌皮（PMMC）皮瓣仍然是重建口腔缺损的广泛使用的工具。但是不可靠和不稳定的血管供应会导致并发症，如皮瓣丢失，口皮瘘和伤口裂开。已建议保留胸外侧动脉（LTA）以改善皮肤桨的血管分布。本研究旨在比较保留或牺牲LTA后的并发症和皮瓣相关结果，同时使用双折叠的PMMC皮瓣重建口腔缺损。材料与方法：回顾性分析2022年1月至2022年9月间采用双折叠PMMC皮瓣重建的61例男性患者的资料。36例患者使用PMMC皮瓣重建，其中LTA被处死，而在25例患者中，LTA得以保留。从患者因素和皮瓣相关并发症方面分析数据。结果：包括主要/次要并发症在内的总并发症率为44.26％，其中皮瓣脱离为22.95％是观察到的最常见并发症。13.11％的患者发生了口皮瘘，部分和完全皮瓣丢失分别为9.83％和4.91％。LTA保存仅与降低的皮瓣脱离率显着相关（p值<0.05）。其他皮瓣相关并发症与LTA保存之间没有显着关联。结论：用保留LTA的PMMC皮瓣重建较大的缺损有助于改善皮瓣的血管状况，减少各种主要/次要皮瓣相关并发症。
■在线版本包含补充材料，可在10.1007/s12070-023-04123-3获得。
■在线版本包含补充材料，可在10.1007/s12070-023-04123-3获得。
