FACIAL RECONSTRUCTION WITH PREFABRICATED INDUCED EXPANDED (PIE) SUPRACLAVICULAR SKIN FLAPS
FACIAL RECONSTRUCTION WITH PREFABRICATED INDUCED EXPANDED (PIE) SUPRACLAVICULAR SKIN FLAPS
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DOI：
10.1097/00006534-199505000-00008
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发表时间：
1995-05-01
影响因子：
3.6
通讯作者：
YOUNG, VL
中科院分区：
文献类型：
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作者：
KHOURI, RK;OZBEK, MR;YOUNG, VL
预制诱导扩张锁骨上皮瓣是指以筋膜瓣为载体，将扩张后的锁骨上皮肤分期转移。在三位病人中，我们利用PIE锁骨上皮瓣成功地重建了全额部和鼻部的缺损。我们的第一个PIE皮瓣证实了该方法的可行性，但需要两个微血管游离皮瓣。在随后的两个病人中，我们通过在一期或二期使用简单的带蒂皮瓣转移减少了微血管闭塞的需要。只要可行，首选的方法包括将颞顶筋膜瓣转移到同侧锁骨上窝的皮下袋中，并同时在筋膜瓣和锁骨上皮肤下放置皮肤扩张器。充分扩张后，筋膜与扩张器的包膜融合，复合包膜筋膜皮瓣可以安全地转移到面部缺损的PIE皮瓣。这些患者表明，锁骨上PIE皮瓣可以提供足够的血管化皮肤组织重建面部大面积缺损。通过扩张可用的最期望的组织类型来产生必要的组织，并且诱导所选择的血管蒂来灌注和携带所产生的组织。与传统的扩张和邻近皮瓣转移相比，PIE皮瓣允许将扩张的皮肤转移到远端部位，作为由诱导血管蒂灌注的岛状或游离皮瓣。
The prefabricated induced expanded (PIE) supraclavicular flap refers to the staged transfer of an expanded supraclavicular skin with a fascia flap used as the carrier. In three patients, we utilized PIE supraclavicular flaps to successfully reconstruct a total forehead and mio major nasal defects. Our first PIE flap confirmed the feasibility of the method but necessitated two microvascular free flaps. In the ensuing two patients, we reduced the need for microvascular anastomoses by using simple pedicled flap transfers in either or both stages. Whenever feasible, the preferred method consists of transferring a temporoparietal fascia flap to a subcutaneous pocket in the ipsilateral supraclavicular fossa and simultaneously placing a skin expander under both the fascia flap and the supraclavicular skin. After adequate expansion, the fascia becomes incorporated within the capsule of the expander, and the composite capsulofasciocutaneous flap can be safely transferred to the facial defect as the PIE flap.These patients show that supraclavicular PIE flaps can provide ample amounts of vascularized cutaneous tissue for the reconstruction of major facial defects. The necessary tissue is generated by expanding the most desirable tissue type available, and a selected vascular pedicle is induced to perfuse and carry that generated tissue. Compared with conventional expansion and adjacent flap transfers, PIE flaps allow the transfer of expanded skin to distant sites as island or free flaps perfused by the induced vascular pedicles.