目的:股深动脉穿支皮瓣(PAPFs)尚未广泛用于头颈部重建。需要研究PAPF用于各种头颈部重建的可行性和结果。
方法:回顾性分析。
方法:单机构审查。
方法:从2019年到2021年,PAPF被用于头颈部重建。局部解剖学,外科技术,并对并发症进行了讨论。描述了具有肌肉成分的嵌合PAPF应用,以覆盖广泛的多单位缺陷。此外,比较了股前外侧穿支皮瓣的美学和功能结局.
结果:共33例。平均年龄为54.2岁(范围,30-74).最常见的病理基础是口腔鳞状细胞癌(n=26,78.8%),而平均±SD体重指数为25.4±2.8kg/m2。中射孔器(n=14,42.4%)是最常用的射孔器。基于穿孔器的嵌合/复合应用在9个(27.3%)中使用,肌肉成分由gracilis(n=3,9.1%)组成,内收肌(n=5,15.2%),或半膜肌(n=1,3.0%)。2例(6.1%)发现PAPF的静脉血栓形成,虽然被打捞了。术后90天发病率(并发症)的发生与下颌骨切除术/上颌骨切除术有关(P=0.020)。术后验证问卷显示中等到高分的趋势,表明在几个类别中的非劣质结果,与股前外侧穿支皮瓣相比。
结论:PAPF是中等到大头颈部重建的良好重建替代方案。此外,PAPF可以提供足够的组织体积和潜在结合相邻肌肉组分的多功能性。
Profunda femoris artery perforator flaps (PAPFs) have not been widely used in head and neck reconstructions. The feasibility and outcomes of PAPFs for various head and neck reconstructions need to be investigated.
Retrospective analysis.
A single-institution review.
PAPFs were utilized in head and neck reconstructions from 2019 to 2021. Local anatomy, surgical technique, and complications were discussed. Chimeric PAPF applications with muscle components were described for coverage of extensive multiunit defects. Additionally, aesthetic and functional outcomes were compared with anterolateral thigh perforator flaps.
A total of 33 cases were included. The average age was 54.2 years (range, 30-74). The most common underlying pathology was oral squamous cell carcinoma (n = 26, 78.8%), while the mean ± SD body mass index was 25.4 ± 2.8 kg/m2 . Middle perforators (n = 14, 42.4%) were the most commonly utilized ones. The perforator-based chimeric/composite applications were used in 9 (27.3%), with the muscular components consisting of gracilis (n = 3, 9.1%), adductor magnus (n = 5, 15.2%), or semimembranosus muscles (n = 1, 3.0%). Venous thromboses of the PAPFs were found in 2 (6.1%), though salvaged. The occurrence of postoperative 90-day morbidity (complication) was related to mandibulectomy/maxillectomy (P = .020). Postoperative validated questionnaires showed a trend of intermediate to high scores, indicating noninferior outcomes in several categories, when compared with the anterolateral thigh perforator flap counterparts.
PAPFs are a good reconstructive alternative for intermediate to large head and neck reconstructions. Besides, PAPFs can provide sufficient tissue volume and versatility of potentially incorporating adjacent muscle components.