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作者报告最近3年半以来应用肩胛骨旁游离皮瓣一期重建29例头颈癌手术后缺损的经验。适应症包括颅面缺损、头皮缺损、口咽部软组织缺损,或伴下颌骨及软组织缺失、覆盖颈动脉等。29例中男21、女8,年龄29～91岁,平均50.1岁。2例死于手术后颈内动脉出血及其后遗症,7例在随访期间因肿瘤复发死亡,7例生存伴局部复发或远处转移,另外3例死亡原因与手术无关。并发症包括皮瓣全部脱失、伤口破裂伴口咽瘘、下颌骨骨髓炎、牙关紧闭、颈部挛缩、皮瓣供区伤口裂开等。手术重建的成功率为93%。肩胛骨旁游离皮瓣属筋膜皮瓣,血液供应来自旋肩胛动脉。血管蒂长达7～8cm,血管直径2～3mm,适合微血
The authors report the first three and a half years since the application of scapular flap free flap reconstruction of 29 cases of head and neck cancer after surgery experience. Indications include craniofacial defects, scalp defects, oropharyngeal soft tissue defects, or with mandibular and soft tissue defects, covering the carotid artery. 29 cases of male 21, female 8, aged 29 to 91 years, mean 50.1 years old. 2 died of internal carotid artery hemorrhage and its sequelae after surgery, 7 died of tumor recurrence during follow-up, 7 survived with local recurrence or distant metastasis, and the other 3 died unrelated to surgery. Complications included the complete loss of flaps, rupture of the wound with oropharyngeal fistula, mandibular osteomyelitis, tightness of the mouth, contracture of the neck and splitting of the flap for wounds. The success rate of surgical reconstruction was 93%. Adjacent to the scapula flap is a fascia flap, blood supply from the spinous artery. Vascular pedicle up to 7 ~ 8cm, vascular diameter 2 ~ 3mm, suitable for micro blood