Application Of Soleus Muscle Lateral Crus Perforator Flap In Repair Of Oral And Maxillofacial Defects

Objective Large defects of soft and hard tissue in the oral and maxillofacial region need to be repaired in time to restore patients' facial appearance and oral-maxillofacial function.At present,various autologous tissue flaps are used for transplantation and repair,with different wound sizes and different effects.In order to minimize the surgical trauma,avoid the residual sequelae of the donor region,reduce the risk of tissue flap crisis or necrosis,and provide tissue flaps with the right amount of tissue and ideal shape,clinical workers and researchers have been conducting various studies and attempts,and have achieved fruitful results.Perforator flaps is one kind of them,which are commonly used clinically.The lateral calf flap is one kind of perforator flaps with the percutaneous branch of the peroneal artery as the vascular pedicle,and there have been few reports about its application in the reconstruction of oral and maxillofacial soft tissue defects.Particularly,the soleus muscle myocutaneous perforator flap on the outside of the calf has the characteristics of larger vascular diameter,lower vascular variability,moderate amount of soft tissue of the flaps.Its skin color is close to the facial skin and soft texture is good for repairing the oral mucosa.Moreover,its location is hidden,and the wound can generally be directly closed and sutured.When used alone,the arteriovenous trunks can be protected.Therefore,in clinical application,the preparation is simpler,the trauma is less,and no obvious postoperative complications are caused.Thus,the patients favor this kind of flaps.In view of this,this study uses the soleus muscle skin perforator lateral calf flap or combined fibula muscle flap for oral and maxillofacial defect repair in order to explore the application and value of the soleus muscle skin perforator lateral calf flap in construction of oral and maxillofacial defects.Methods In this retrospectively study,ten patients with oral and maxillofacial malignancies who were admitted to the Department of Oral and maxillofacial Surgery in Fuyang People's Hospital during the period from May 2016 to March 2019 were enrolled.8 cases of soleus muscle percutaneous perforator lateral calf flap and 2 cases of combined peroneus flap were used.The time length of the operation,the length of the vascular pedicle,the size of the flap,the survival of the flap and the healing of the wound after the operation,arterial crisis were recorded.The application effects of the soleus musculocutaneous perforator lateral calf flaps were analyzed.At 1 month and 3 months after surgery,oral function recovery,donor site recovery,quality of life and surgical satisfaction were recorded.The evaluations of oral function include speech intelligibility and swallowing function.The University of Washington Quality of Life Scale(UW-QOC)was used to evaluate the postoperative quality of life of patients.Statistical analysis was performed using SPSS 20.0 software.The measurement data did not conform to the normal distribution.After the data was converted to the normal distribution,a paired sample t-test was performed.Count data examples or percentage(%).The test level ? = 0.05 was a two-sided test,and P <0.05 was considered statistically significant.Results The operations were successful in all 10 patients without skin flap necrosis or serious complications.At the time of 1 month after operation,3 of the 10 patients' speech functions were grade 2 and 2 of the 10 patients' swallowing functions were grade 2.3 months after operation,both speech and swallowing function reached grade 3.1 month after surgery,patients had hypertrophic scars,donor site itching,parenthesis and dysfunction.3 months after surgery,there was 1 case of hypertrophic scars and one case of donor site itching,all cases did not company abnormalities and dysfunction.Compared with 1 month after surgery,the social function score and body function score in the University of Washington Quality of Life Scal(UW-QOC)increased at 3 months after surgery,and the difference was statistically significant(P <0.05);the patients' satisfaction rate at 1 month after surgery was 80.00%,and it was 90.00% at 3 months after surgery.Conclusion The soleus muscle musculocutaneous perforator lateral calf flap is one kind of ideal free flaps for repairing oral-maxillofacial defects.Postoperative oral function,donor site recovery is good,quality of life and surgical satisfaction are high,and it is worthy of clinical promotion and application in oral and maxillofacial surgery.