背景:大全厚度唇缺损是重建的挑战。
目的:描述减压角肌皮(DAOM)皮瓣作为轴型转位皮瓣重建大型,全厚唇缺陷。
方法:对2011年至2018年接受DAOM皮瓣重建的大型全层唇缺损成人进行多中心回顾性队列研究。对DAOM皮瓣的解剖结构和手术技术进行了综述。皮瓣活力的主要结果以及术后并发症和功能结果的其他临床结果被记录,随访长达11年。分析了平均住院时间和平均机构护理成本。
结果:共有12例患者接受了DAOM皮瓣重建,以修复大型全层唇缺损。皮瓣存活100%,没有再手术或再入院。所有患者报告维持不同的口腔连合,宽的口腔开口和完整的牙龈沟,优秀的口语能力,和可理解的演讲。平均病例长度为144±11.5分钟,平均住院时间为1.6±0.5天,估计平均机构费用为$3766.67±$1167.06。
结论:DAOM皮瓣是治疗大型全厚度唇缺损的一种极好的重建选择,具有强大的功能效果和有限的供体部位发病率和机构护理成本。
BACKGROUND: Large full-thickness lip defects present a reconstructive challenge.
OBJECTIVE: To describe the impact on clinical outcomes and institutional cost of the depressor anguli oris myocutaneous (DAOM) flap as an axial pattern transposition flap for reconstruction of large, full-thickness lip defects.
METHODS: A multicenter retrospective cohort study of adults with large full-thickness lip defects who underwent DAOM flap reconstruction from 2011 to 2018 was conducted. DAOM flap anatomy and surgical technique were reviewed. The primary outcome of flap viability as well as additional clinical outcomes of postoperative complications and functional results were documented with follow-up ranging up to 11 years. Median length of stay and average institutional cost of care were analyzed.
RESULTS: A total of 12 patients underwent DAOM flap reconstruction for large full-thickness lip defects. There was 100% flap survival with no episodes of reoperation or readmission. All patients reported maintenance of distinct oral commissures, wide oral opening and full gingivolabial sulcus, excellent oral competence, and intelligible speech. Mean case length was 144 ± 11.5 min with a mean length of stay of 1.6 ± 0.5 days and estimated mean institutional cost of $3766.67 ± $1167.06.
CONCLUSIONS: The DAOM flap is an excellent reconstructive option for large full-thickness lip defects with strong functional results and limited donor site morbidity and institutional cost of care.