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目的:探讨前臂游离带蒂血管皮瓣及股外侧筋膜组织联合应用即刻修复下唇部软组织全层缺损的临床效果。方法:对因外伤后的下唇部软组织全层缺损的创面用前臂桡侧游离皮瓣及股外侧筋膜联合修复13例,应用显微外科技术将桡动脉与面动脉吻合,头静脉与颈外静脉吻合。结果:联合即刻修复下唇部各类全层软组织缺损13例,全部存活;1例皮瓣远端少许坏死,经换药治疗后完全愈合。术后随访1~36个月,成活的皮瓣质地优良,与基底附着良好,外观比较满意,未见塌陷下垂,功能及口角恢复良好。结论:股外侧筋膜及前臂游离带蒂皮瓣联合即刻修复下唇全层缺损(尤其双侧口角缺损),对外观修复及功能恢复优越于其他治疗方法。
Objective: To investigate the clinical effect of combined application of free forearm pedicled vascular flap and lateral femoral fascia in the immediate repair of soft tissue defect of the lower lip. Methods: Thirteen cases were repaired by the combination of the radial forearm free flap and the lateral femoral fascia after the trauma with the soft tissue defect of the lower lip. Thirteen patients were repaired by microsurgery. The radial artery and the facial artery were anastomosed. The cephalic vein and neck External venous anastomosis. Results: Thirteen cases of full thickness soft tissue defect of the lower lip were all repaired instantly, and all survived. One case of distal flap was slightly necrotic and completely healed after dressing change. After 1 to 36 months of follow-up, the surviving flap was of excellent texture, good adhesion to the basement, satisfactory appearance and no collapse and sag. The function and mouth angle were recovered well. Conclusion: The lateral femoral fascia and the forearm free pedicle flap combined with immediate restoration of the full thickness of the lower lip defect (especially bilateral defect), the appearance of repair and functional recovery superior to other treatment methods.