PDF(Pubmed)
Abstract：
Background Anterolateral thigh (ALT) flap is the most common soft tissue flap used for microvascular reconstruction of head and neck. Its harvest is associated with some unpredictability due to variability in perforator characteristics, injury or unfavorable configuration for complex defects. Anteromedial thigh (AMT) flap is an option, but the low incidence and thickness restrict its utility. Tensor fascia lata (TFL) perforator (TFLP) flap is an excellent option to complement ALT. Its perforator is consistent, robust, in vicinity, and lends itself with the ALT perforator. Methods This study was an analysis of 29 cases with a free flap for head neck reconstruction with an element of TFLP flap from July 2017 to May 2021. Results All cases were primarily planned for an ALT reconstruction. There was absence of the ALT perforator in 16 cases but a sizable TFL perforator was available. In 13 cases, the complex defect warranted use of both ALT plus TFL in a conjoint (5), chimeric (5), and multiple (3) free flaps manner. Most common perforator location was septocutaneous between the TFL and gluteus medius. There was complete flap loss in two cases and partial necrosis in two. No adjuvant therapy was delayed. Conclusion TFLP can reliably complement the ALT/AMT axis. Chimeric ALT-TFL can be harvested for large, complex, multicomponent, and multidimensional defects.
摘要：
背景股前外侧（ALT）皮瓣是最常见的用于头颈部微血管重建的软组织皮瓣。由于射孔器特性的可变性，其收获与一些不可预测性有关，复杂缺陷的损伤或不利配置。前内侧大腿（AMT）皮瓣是一种选择，但低发生率和厚度限制了其实用性。张量筋膜（TFL）穿支（TFLP）皮瓣是补充ALT的绝佳选择。它的穿孔器是一致的，健壮,在附近,并使用ALT穿孔器。方法分析2017年7月至2021年5月29例游离皮瓣以TFLP皮瓣为元素进行头颈重建的临床资料。结果所有病例均计划进行ALT重建。16例没有ALT穿孔器，但有相当大的TFL穿孔器可用。在13个案例中，复杂的缺陷需要同时使用ALT加TFL（5），嵌合（5），和多（3）自由襟翼方式。最常见的穿孔器位置是TFL和臀中肌之间的隔膜。2例皮瓣完全丢失，2例部分坏死。没有延迟辅助治疗。结论TFLP能可靠地补充ALT/AMT轴。嵌合ALT-TFL可以收获大，复杂，多组分,和多维缺陷。
