Baş Boyun Rekonstrüksiyonunda Defekte Uygun Kalınlıkta Anterolateral Uyluk Flebi Kullanımı

Yıl 2023, Cilt: 10 Sayı: 1, 33 - 39, 31.03.2023

Merve Özkaya Ünsal , Yavuz Tuluy , Zülfükar Ulaş Bali , Aziz Parspancı

https://doi.org/10.34087/cbusbed.1161917

Öz

Giriş ve Amaç: Bu çalışmada doku defektin kalınlığına göre farklı cerrahi planlarda eleve edilen anterolateral uyluk flebi (ALT) ile rekonstrüksiyon deneyimlerimizin paylaşılması amaçlanmıştır.
Gereç ve Yöntemler: Mart 2017'den Aralık 2020'ye kadar subfasyal, süper ince, suprafasyal, kimerik ve kompozit flepler dahil olmak üzere farklı ALT flebi cerrahi planları ile baş ve boyun defektlerinin rekonstrüksiyonu yapılan 25 hastada 26 flep içeren retrospektif bir çalışma yapıldı. Flep elevasyon planları, operasyon sırasında cetvel kullanılarak belirlenen defektin kalınlığına göre seçildi. Flep kalınlıkları, komplikasyonlar ve revizyon oranları değerlendirildi.
Bulgular: Süper ince fleplerden biri total nekroz oldu; başka flep kaybı olmadı. Postoperatif dönemde üç hasta öldü. Uygun flep elevasyon planı seçilmesine rağmen, 26 flepten 4'ünde revizyon cerrahisi yapıldı. Süper ince ALT flebi ile dudak rekonstrüksiyonu yapılan hastalardan birind postoperatif 6. ayda bulky bir görünüm mevcuttu ve subfasyal ALT flebi uygulanan 3 hastaya inceltme ameliyatı yapıldı.
Sonuç: ALT flep, baş boyun bölgesindeki defektin kalınlığına göre farklı planlarda eleve edilebilen güvenilir bir fleptir. Uygun kalınlıktaki ALT flep, revizyon ameliyatları olmadan tek aşamada rekonstrüksiyon sağlar ve optimal estetik sonuçlar alınabilir.

Anahtar Kelimeler

Anterolateral uyluk flebi, serbest flep, baş boyun rekonstrüksiyonu.

Use of Customized Thickness Anterolateral Thigh Flap in Head and Neck Reconstruction

Öz

Objective: This study demonstrates different techniques of anterolateral thigh flap (ALT) with the appropriate surgical planes according to the thickness of the defect, which have not been previously found in the literature, with our reconstruction experiences.
Materials and Methods: A retrospective study was performed including 26 flaps in 25 patients who underwent reconstruction of head and neck defects with different surgical planes of ALT flap including subfascial, superthin, suprafascial, chimeric and composite flaps from March 2017 through December 2020. Flap planes were chosen according to the thickness of the defect, determined during surgery by using caliper. We evaluated the characteristics, flap thicknesses, complications and need of revision surgery in postoperative period.
Results: One of the superthin flaps was totally lost; there was not any other flap loss. Three patients died in postoperative period. Although appropriate plane of the flaps was chosen, 4 of all 26 flaps needed revision surgery. One of the patients who was performed lip reconstruction with superthin ALT flap had bulky appearance needed liposuction in postoperative 6 months and 3 patients who received subfascial ALT flaps were performed debulking surgeries.
Conclusion: ALT flap is a versatile, reliable flap which can be harvested in different planes according to the thickness of the defect in head and neck region. The ALT flap with convenient thickness provides definitive reconstruction in a single stage without revision surgeries and the most optimal aesthetic results can be obtained.

Anahtar Kelimeler

Anterolateral thigh flap, Free flaps, Head and neck reconstruction., Anterolateral thigh flap, Free flaps, Head and neck reconstruction.

Kaynakça

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