| Background: Defects of maxillofacial soft tissue are often caused by trauma and tumors,which directly or indirectly lead to defects in appearance and functional obstacles,which have a serious impact on daily life.For the remaining wound repair,it is usually necessary to use nearby or distant flaps for reconstruction.The purpose of traditional skin flap repair is to make the skin flap alive and achieve wound healing.It has not paid enough attention to the restoration of the shape and function of the flap receiving area,especially the damage of the skin flap donor area.In recent years,with the establishment of the concept of "minimally invasive and precise" flap surgery,the status of perforator flaps has gradually emerged.The lower abdominal superficial artery perforator flap(Superficial inferior epigastric artery perforator flap or Superficial circumflex iliac artery perforator flap)is located in the "swimming trunk donor area" of the lower abdomen,with less damage,hidden location and fewer complications,which is in line with the concept of modern surgical skin flap.However,in the past,the flap was mainly applied to breasts,limbs and other parts,and it was rarely applied in the oral and maxillofacial region.Objectives: Simultaneous application of the lower abdominal superficial artery perforator flap and forearm flap to repair the maxillofacial soft tissue defects in patients with oral cancer after surgery,compare the complications and clinical effects of the donor of the two kinds of flaps,and evaluate the lower abdominal superficial artery the value of perforator flap in clinical application.Methods: Selected patients with oral cancer who were hospitalized in the Oral and Maxillofacial Surgery Department of the First Affiliated Hospital of Bengbu Medical College from July 2018 to January 2020.A retrospective and comparative analysis of 15 patients who underwent the lower abdominal superficial artery perforator flap(superficial inferior epigastric artery perforator flap or superficial circumflex iliac artery perforator flap)repair due to enlarged resection of the lesion,and the incidence of postoperative complications in the donor and recipient areas of 15 patients who underwent forearm flap repair at the same time.Subjective and objective methods are used to evaluate and compare the donor site and function,and patient satisfaction,etc.Results: There was no statistical difference between the two groups in the functional recovery of the recipient area after surgery(P>0.05),In the case of repairing the soft tissue defect after oral cancer with the lower abdominal superficial artery perforator flap,the donor wound surface was separated by stealth and closed and sutured directly,and only linear scars were left after the operation,which had a slight impact on aesthetics and function.However,in the patients repaired with forearm flaps,skin grafts were used to repair the wounds in the donor area,and postoperative scar hyperplasia and pigmentation were more obvious in the donor area.The comparison of subjective feelings in the donor area after operation showed that there was a statistically significant difference between the two groups in sensory abnormalities and appearance of the donor area(P<0.05).In the objective examination of function and appearance,the differences between the two groups were statistically significant(P<0.05),and the forearm group had more obvious complications of donor site.The functional recovery of the recipient area and the subjective satisfaction of the patients were basically similar between the two groups.Conclusion: In the repair of maxillofacial soft tissue defects,the two groups of skin flaps have achieved satisfactory results.The lower abdominal superficial artery perforator flap is used for repair,with fewer complications in the donor area,little impact on the appearance and function of the donor area,and is a good choice for repairing soft tissue defects of the oral and maxillofacial region. |
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