COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YANGHeping , ZHANGHongwu , CHENHaidi , YANGShuxiong , WANGJun , HUDawang

Department of Oral and Maxillofacial Surgery, the Xiangtan City Central Hospital, Xiangtan Hunan, 411100, P. R. China;

Corresponding?author：

YANGHeping, Email: yangheping314@sina.com

Keywords：

Chimeric anterolateral thigh flap; Series-wound flaps; Oral and maxillofacial cancer; Defect reconstruction

DOI：

10.7507/1002-1892.20160090

Video：

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Objective To compare the effectiveness of complex defects repair between using chimeric anterolateral thigh flap and series-wound flaps after resection of oral and maxillofacial cancer. Method After resection of oral and maxillofacial cancer, defect was repaired with chimeric anterolateral thigh flap in 39 patients between January 2011 and July 2014 (chimeric anterolateral thigh flap group); and defect was repaired with series-wound flaps in 35 patients between January 2009 and December 2010 (series-wound flaps group). There was no significant difference in gender, age, duration of disease, tumor type, tumor staging, defect location, and defect area between 2 groups (P>0.05) . The operation time, flap harvesting and microvascular anastomosis time, stomach tube extraction time, and oral feeding time were recorded and compared between 2 groups, and postoperative complications were observed; the effectiveness was evaluated according to clinical efficacy evaluation table of bone and soft tissue defects reconstruction surgery in oral and maxillofacial region. Results Vascular crisis occurred in 2 cases of chimeric anterolateral thigh flap group, and 4 cases of series-wound flaps group. Partial necrosis appeared at distal end of a series-wound flaps, and oral fistula and infection developed in 3 series-wound flaps. The other flaps and the grafted skin at donor site survived; wounds at recipient site healed by first intention. The operation time, stomach tube extraction time, and oral feeding time of chimeric anterolateral thigh flap group were significantly shorter than those of series-wound flaps group (P<0.05) , while the flap harvesting and microvascular anastomosis time was significantly longer than that of series-wound flaps group (P<0.05) . The patients were followed up 1-5 years (mean, 2.5 years). At 3 months after operation, the appearance, patients' satisfaction, working conditions, oral closure function, chew, language performance, and swallowing scores of the chimeric anterolateral thigh flap group were significantly better than those of the series-wound flaps group (P<0.05) , while there was no significant difference in diet, mouth opening degree, oral cavity holding water test, and occlusion scores between the 2 groups (P>0.05) . Conclusions Using chimeric anterolateral thigh flap for defect repair after resection of oral and maxillofacial cancer can significantly shorten the operation time, accelerate postoperative rehabilitation, and help the functional recovery of oral closure, chewing, language performance, swallowing function when compared with the series-wound flaps.

Citation： YANGHeping, ZHANGHongwu, CHENHaidi, YANGShuxiong, WANGJun, HUDawang. COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 447-452. doi: 10.7507/1002-1892.20160090 Copy

1.	魏在榮. 影響皮瓣成活的血管因素分析. 中國美容整形外科雜志, 2014, 25(3) :129-131.
2.	王金龍, 徐斌, 王兵, 等. 髂腹股溝皮瓣聯合帶蒂股前外側皮瓣修復手部大面積皮膚缺損. 重慶醫學, 2013, 42(2) :197-198.
3.	陳睿, 李雯娟, 楊凱, 等. 股前外側皮瓣在口腔頜面外科的臨床應用. 重慶醫科大學學報, 2014, 39(8) :1160-1162.
4.	徐立群, 張陳平, 張志愿, 等. 血管化游離組織瓣在口腔頜面-頭頸部缺損修復中的應用(4640例臨床分析). 實用腫瘤雜志, 2015, 30(1) :18-21.
5.	雷林革, 袁崇喜, 何如祥, 等. 游離股前外筋膜瓣修復手部軟組織缺損. 實用手外科雜志, 2013, 27(2) :118-120.
6.	Yamada S, Okamoto H, Sekiya I, et al. Anatomical basis of distally based anterolateral thigh flap. J Plast Surg Hand Surg, 2014, 48(3) :197-200.
7.	Wei ZR, Sun GF, Wang DL, et al. Reconstruction of the Achilles tendon and overlying skin defect:3 case reports. Ann Plast Surg, 2014, 73(3) :325-329.
8.	Zhuang Y, Hu S, Wu D, et al. A novel in vivo technique for observations of choke vessels in a rat skin flap model. Plast Reconstr Surg, 2012, 130(2) :308-317.
9.	Ao M, Asagoe K, Maeta M. Combined anterior thigh flaps and vascularized fibular graft for reconstruction of massive composite oromandibular defects. Br J Plast Surg, 1998, 51(5) :350-355.
10.	Singh B, Cordeiro PG, Santamaria E, et al. Factors associated with complications in microvascular reconstruction of head and neck defects. Plast Reconstr Surg, 1999, 103(2) :403-411.
11.	Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck, 2004, 26(9) :759-769.
12.	Rogers SN, Lowe D. The University of Washington Quality of Life Scale//Handbook of Disease Burdens and Quality of Life Measures. New York:Springer, 2010:101-128.
13.	羅瑞華, 齊金星, 趙銘, 等. 削薄股前外側皮瓣游離移植修復舌癌術后缺損的臨床療效. 武漢大學學報(醫學版), 2012, 33(4) :585-586,593.
14.	唐修俊, 魏在榮, 王波, 等. 游離旋股外側動脈穿支KISS皮瓣修復四肢創面的臨床應用. 中華顯微外科雜志, 2015, 38(1) :29-32.
15.	Hallock GG. Simultaneous transposition of anterior thigh muscle and fascia flaps:an introduction to the chimera flap principle. Ann Plast Surg, 1991, 27(2) :126-131.
16.	杜學亮, 陳平, 杜永軍, 等. 串聯皮瓣修復大面積顱骨外露. 中國美容醫學, 2012, 21(3) :360-362.
17.	徐中飛, 代煒, 張恩礁, 等. 股前外側穿支嵌合皮瓣修復頭頸腫瘤根治術后缺損. 上海口腔醫學, 2012, 21(1) :107-112.
18.	陳潔, 蔣燦華, 閔安杰, 等. 旋髂深動脈穿支嵌合髂骨皮瓣修復下頜骨復合性缺損. 華西口腔醫學雜志, 2015, 33(3) :276-280.
19.	Bhadkamkar MA, Wolfswinkel EM, Hatef DA, et al. The ultra-thin, fascia-only anterolateral thigh flap. J Reconstr Microsurg, 2014, 30(9) :599-606.
20.	Goel S, Arora J, Mehta V, et al. Unusual disposition of lateral circumflex femoral artery:Anatomical description and clinical implications. World J Clin Cases, 2015, 3(1) :85-88.
21.	Lee YC, Chen WC, Chou TM, et al. Anatomical variability of the anterolateral thigh flap perforators:vascular anatomy and its clinical implications. Plast Reconstr Surg, 2015, 135(4) :1097-1107.
22.	蔡志剛, 孫堅. 顯微外科技術在口腔頜面及頭頸部修復與重建中的應用. 中華顯微外科雜志, 2014, 37(5) :417-420.
23.	Taylor GI, Gorlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries:developent of the concept and designing safe flap. Plast Resonstr Surg, 2011, 127(4) :1447-1459.
24.	陳丹, 楊凱, 陳睿, 等. 股前外側皮瓣在口腔頜面部腫瘤術后缺損修復中的應用. 重慶醫科大學學報, 2014, 39(1) :125-126.
25.	肖海濤, 時瑩瑜, 王懷勝, 等. 高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用. 中國修復重建外科雜志, 2013, 27(2) :178-181.
26.	陳潔, 蔣燦華, 尹乒, 等. 股前外側free-style穿支皮瓣在口腔頜面部缺損修復重建中的應用. 中華顯微外科雜志, 2015, 38(1) :20-24.

1. 魏在榮. 影響皮瓣成活的血管因素分析. 中國美容整形外科雜志, 2014, 25(3) :129-131.
2. 王金龍, 徐斌, 王兵, 等. 髂腹股溝皮瓣聯合帶蒂股前外側皮瓣修復手部大面積皮膚缺損. 重慶醫學, 2013, 42(2) :197-198.
3. 陳睿, 李雯娟, 楊凱, 等. 股前外側皮瓣在口腔頜面外科的臨床應用. 重慶醫科大學學報, 2014, 39(8) :1160-1162.
4. 徐立群, 張陳平, 張志愿, 等. 血管化游離組織瓣在口腔頜面-頭頸部缺損修復中的應用(4640例臨床分析). 實用腫瘤雜志, 2015, 30(1) :18-21.
5. 雷林革, 袁崇喜, 何如祥, 等. 游離股前外筋膜瓣修復手部軟組織缺損. 實用手外科雜志, 2013, 27(2) :118-120.
6. Yamada S, Okamoto H, Sekiya I, et al. Anatomical basis of distally based anterolateral thigh flap. J Plast Surg Hand Surg, 2014, 48(3) :197-200.
7. Wei ZR, Sun GF, Wang DL, et al. Reconstruction of the Achilles tendon and overlying skin defect:3 case reports. Ann Plast Surg, 2014, 73(3) :325-329.
8. Zhuang Y, Hu S, Wu D, et al. A novel in vivo technique for observations of choke vessels in a rat skin flap model. Plast Reconstr Surg, 2012, 130(2) :308-317.
9. Ao M, Asagoe K, Maeta M. Combined anterior thigh flaps and vascularized fibular graft for reconstruction of massive composite oromandibular defects. Br J Plast Surg, 1998, 51(5) :350-355.
10. Singh B, Cordeiro PG, Santamaria E, et al. Factors associated with complications in microvascular reconstruction of head and neck defects. Plast Reconstr Surg, 1999, 103(2) :403-411.
11. Yu P. Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck, 2004, 26(9) :759-769.
12. Rogers SN, Lowe D. The University of Washington Quality of Life Scale//Handbook of Disease Burdens and Quality of Life Measures. New York:Springer, 2010:101-128.
13. 羅瑞華, 齊金星, 趙銘, 等. 削薄股前外側皮瓣游離移植修復舌癌術后缺損的臨床療效. 武漢大學學報(醫學版), 2012, 33(4) :585-586,593.
14. 唐修俊, 魏在榮, 王波, 等. 游離旋股外側動脈穿支KISS皮瓣修復四肢創面的臨床應用. 中華顯微外科雜志, 2015, 38(1) :29-32.
15. Hallock GG. Simultaneous transposition of anterior thigh muscle and fascia flaps:an introduction to the chimera flap principle. Ann Plast Surg, 1991, 27(2) :126-131.
16. 杜學亮, 陳平, 杜永軍, 等. 串聯皮瓣修復大面積顱骨外露. 中國美容醫學, 2012, 21(3) :360-362.
17. 徐中飛, 代煒, 張恩礁, 等. 股前外側穿支嵌合皮瓣修復頭頸腫瘤根治術后缺損. 上海口腔醫學, 2012, 21(1) :107-112.
18. 陳潔, 蔣燦華, 閔安杰, 等. 旋髂深動脈穿支嵌合髂骨皮瓣修復下頜骨復合性缺損. 華西口腔醫學雜志, 2015, 33(3) :276-280.
19. Bhadkamkar MA, Wolfswinkel EM, Hatef DA, et al. The ultra-thin, fascia-only anterolateral thigh flap. J Reconstr Microsurg, 2014, 30(9) :599-606.
20. Goel S, Arora J, Mehta V, et al. Unusual disposition of lateral circumflex femoral artery:Anatomical description and clinical implications. World J Clin Cases, 2015, 3(1) :85-88.
21. Lee YC, Chen WC, Chou TM, et al. Anatomical variability of the anterolateral thigh flap perforators:vascular anatomy and its clinical implications. Plast Reconstr Surg, 2015, 135(4) :1097-1107.
22. 蔡志剛, 孫堅. 顯微外科技術在口腔頜面及頭頸部修復與重建中的應用. 中華顯微外科雜志, 2014, 37(5) :417-420.
23. Taylor GI, Gorlett RJ, Dhar SC, et al. The anatomical (angiosome) and clinical territories of cutaneous perforating arteries:developent of the concept and designing safe flap. Plast Resonstr Surg, 2011, 127(4) :1447-1459.
24. 陳丹, 楊凱, 陳睿, 等. 股前外側皮瓣在口腔頜面部腫瘤術后缺損修復中的應用. 重慶醫科大學學報, 2014, 39(1) :125-126.
25. 肖海濤, 時瑩瑜, 王懷勝, 等. 高頻彩色多普勒超聲檢測穿支血管在股前外側皮瓣手術中的應用. 中國修復重建外科雜志, 2013, 27(2) :178-181.
26. 陳潔, 蔣燦華, 尹乒, 等. 股前外側free-style穿支皮瓣在口腔頜面部缺損修復重建中的應用. 中華顯微外科雜志, 2015, 38(1) :20-24.

Chinese Journal of Reparative and Reconstructive Surgery

COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER

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