Application of folded transverse superficial epigastric artery perforator flap for large penetrating defect after buccal carcinoma resection_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Dong , LIU Chang , LIU Liang ,  ZHANG Kai

Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233004, P. R. China;

Corresponding?author：

ZHANG Kai, Email: zk29788@163.com

Keywords：

Transverse flap; superficial epigastric artery perforator flap; folded flap; buccal carcinoma

DOI：

10.7507/1002-1892.202301011

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effectiveness of folded transverse superficial epigastric artery perforator flap in repairing the large penetrating defect after buccal carcinoma resection. Methods Between January 2019 and June 2021, 12 patients with buccal squamous cell carcinoma were treated. There were 6 males and 6 females with an average of 66.9 years (range, 53-79 years). The pathological stage was T3a-T4b, and the preoperative mouth opening was (3.08±0.46) cm. The disease duration ranged from 6 to 24 months, with an average of 15 months. After buccal carcinoma radical resection and neck lymph node dissection, the penetrating defects in size of 8 cm×6 cm to 16 cm×8 cm and in depth of 0.5-1.5 cm were remained. The transverse superficial epigastric artery perforator flap in size of 8 cm×6 cm to 14 cm×8 cm were harvested and folded to repair the penetrating defects. The donor site was sutured directly. Results All 12 skin flaps survived after operation, and the wounds healed by first intention. No internal or external fistula complications occurred. All incisions at the recipient site healed by first intention. All patients were followed up 12-18 months (mean, 14 months). There was no obvious abnormality in the color and texture of the flap, the oral and facial appearances were symmetrical, and there was no obvious swelling in the cheek. At last follow-up, the patient’s mouth opening was (2.89±0.33) cm, which was not significantly different from that before operation (t=1.879, P=0.087). The subjective satisfaction scores of 12 patients were 6-8 points, with an average of 7.3 points. Significant scars remained at the donor site but concealed in location. Conclusion The folded transverse superficial epigastric artery perforator flap can be used as a surgical method for repairing large penetrating defects after the buccal carcinoma resection, with a good recovery of facial appearance and oral function.

Citation： WANG Dong, LIU Chang, LIU Liang, ZHANG Kai. Application of folded transverse superficial epigastric artery perforator flap for large penetrating defect after buccal carcinoma resection. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(5): 601-604. doi: 10.7507/1002-1892.202301011 Copy

1.	Zhou T, Zhang L, Sun G, et al. Ablation of buccal cancer and functionality buccal reconstruction using an individuation anterolateral thigh flap. J Craniofac Surg, 2018, 29(4): e396-e398.
2.	宋達疆, 李贊, 周曉, 等. 游離分葉股前外側穿支皮瓣修復口腔頜面部惡性腫瘤術后頰部洞穿缺損. 中國修復重建外科雜志, 2018, 32(5): 607-611.
3.	馬治超, 孫黎波, 周航宇, 等. 折疊游離前臂皮瓣修復頰癌術后洞穿性缺損的臨床研究. 臨床耳鼻咽喉頭頸外科雜志, 2018, 32(13): 1002-1005.
4.	宋梓維, 伋琳, 周航宇, 等. 雙皮島游離前臂皮瓣在腭部大型洞穿性缺損修復中的應用. 臨床耳鼻咽喉頭頸外科雜志, 2019, 33(12): 1165-1167, 1172.
5.	王棟, 張凱, 徐濤, 等. 數字化三維重建技術輔助腹壁淺動脈皮瓣修復口腔頜面部缺損的應用研究. 中華口腔醫學雜志, 2021, 56(3): 263-267.
6.	Jiang Q, Xue D, Xin Y, et al. A competing risk nomogram for predicting cancer-specific death of patients with buccal mucosa cancer. Oral Dis, 2021, 27(4): 900-910.
7.	Riju J, George NA, Krishna J. AJCC 8th versus AJCC 7th as a prognostic indicator in buccal mucosal squamous cell carcinoma. Indian J Surg Oncol, 2023, 14(1): 228-233.
8.	Jimenez AG, Reategui A, Lopez J. The superficial inferior epigastric artery interpolated flap for closure of large anterolateral thigh flap donor site defects. J Craniofac Surg, 2022, 33(3): e341-e342.
9.	Kita Y, Fukunaga Y, Arikawa M, et al. Anatomy of the arterial and venous systems of the superficial inferior epigastric artery flap: A retrospective study based on computed tomographic angiography. J Plast Reconstr Aesthet Surg, 2020, 73(5): 870-875.
10.	王曉敏, 張凱, 馬士崟, 等. 腹壁淺動脈皮瓣的應用解剖研究. 中國修復重建外科雜志, 2010, 24(11): 1357-1360.
11.	Yoshimatsu H, Hayashi A, Karakawa R, et al. Combining the superficial circumflex iliac artery perforator flap with the superficial inferior epigastric artery flap or the deep inferior epigastric artery perforator flap for coverage of large soft tissue defects in the extremities and the trunk. Microsurgery, 2020, 40(6): 649-655.
12.	宋達疆, 李贊, 章一新. 股前外側嵌合穿支肌皮瓣的制備方式及優化策略研究. 中國修復重建外科雜志, 2023, 37(2): 180-184.
13.	Wu X, Yang R, Yuan Y, et al. Application of a chimeric ALT perforator flap with vastus lateralis muscle mass in the reconstruction of the defects after radical resection of a buccal carcinoma: A retrospective clinical study. J Surg Oncol, 2020, 122(4): 632-638.
14.	Sacher M, Kapalschinski RN, Wallner C, et al. Body mass index and abdominal wall thickness correlate with perforator caliber in free abdominal tissue transfer for breast reconstruction. J Plast Reconstr Aesthet Surg, 2020, 73(3): 494-500.
15.	周鑫, 鄒永根, 唐林, 等. 攜帶雙側腹壁淺動脈的下腹壁聯體皮瓣修復足踝大面積軟組織缺損. 中國修復重建外科雜志, 2021, 35(11): 1467-1471.
16.	Wang D, Gao T, Liu L, et al. Thin superficial inferior epigastric artery perforator flap for reconstruction of the tongue. Br J Oral Maxillofac Surg, 2020, 58(8): 992-996.
17.	Qiao X, Li C, Liu H, et al. Reconstruction of parotid duct defect with autologous vein graft and vascular coupler after buccal mucosa cancer resection. J Stomatol Oral Maxillofac Surg, 2021, 122(6): 608-611.
18.	Bakshi J, Goyal AK, Saini J. Quality of life in oral cancer patients following surgical excision and flap reconstruction. J Maxillofac Oral Surg, 2022, 21(2): 326-331.

1. Zhou T, Zhang L, Sun G, et al. Ablation of buccal cancer and functionality buccal reconstruction using an individuation anterolateral thigh flap. J Craniofac Surg, 2018, 29(4): e396-e398.
2. 宋達疆, 李贊, 周曉, 等. 游離分葉股前外側穿支皮瓣修復口腔頜面部惡性腫瘤術后頰部洞穿缺損. 中國修復重建外科雜志, 2018, 32(5): 607-611.
3. 馬治超, 孫黎波, 周航宇, 等. 折疊游離前臂皮瓣修復頰癌術后洞穿性缺損的臨床研究. 臨床耳鼻咽喉頭頸外科雜志, 2018, 32(13): 1002-1005.
4. 宋梓維, 伋琳, 周航宇, 等. 雙皮島游離前臂皮瓣在腭部大型洞穿性缺損修復中的應用. 臨床耳鼻咽喉頭頸外科雜志, 2019, 33(12): 1165-1167, 1172.
5. 王棟, 張凱, 徐濤, 等. 數字化三維重建技術輔助腹壁淺動脈皮瓣修復口腔頜面部缺損的應用研究. 中華口腔醫學雜志, 2021, 56(3): 263-267.
6. Jiang Q, Xue D, Xin Y, et al. A competing risk nomogram for predicting cancer-specific death of patients with buccal mucosa cancer. Oral Dis, 2021, 27(4): 900-910.
7. Riju J, George NA, Krishna J. AJCC 8th versus AJCC 7th as a prognostic indicator in buccal mucosal squamous cell carcinoma. Indian J Surg Oncol, 2023, 14(1): 228-233.
8. Jimenez AG, Reategui A, Lopez J. The superficial inferior epigastric artery interpolated flap for closure of large anterolateral thigh flap donor site defects. J Craniofac Surg, 2022, 33(3): e341-e342.
9. Kita Y, Fukunaga Y, Arikawa M, et al. Anatomy of the arterial and venous systems of the superficial inferior epigastric artery flap: A retrospective study based on computed tomographic angiography. J Plast Reconstr Aesthet Surg, 2020, 73(5): 870-875.
10. 王曉敏, 張凱, 馬士崟, 等. 腹壁淺動脈皮瓣的應用解剖研究. 中國修復重建外科雜志, 2010, 24(11): 1357-1360.
11. Yoshimatsu H, Hayashi A, Karakawa R, et al. Combining the superficial circumflex iliac artery perforator flap with the superficial inferior epigastric artery flap or the deep inferior epigastric artery perforator flap for coverage of large soft tissue defects in the extremities and the trunk. Microsurgery, 2020, 40(6): 649-655.
12. 宋達疆, 李贊, 章一新. 股前外側嵌合穿支肌皮瓣的制備方式及優化策略研究. 中國修復重建外科雜志, 2023, 37(2): 180-184.
13. Wu X, Yang R, Yuan Y, et al. Application of a chimeric ALT perforator flap with vastus lateralis muscle mass in the reconstruction of the defects after radical resection of a buccal carcinoma: A retrospective clinical study. J Surg Oncol, 2020, 122(4): 632-638.
14. Sacher M, Kapalschinski RN, Wallner C, et al. Body mass index and abdominal wall thickness correlate with perforator caliber in free abdominal tissue transfer for breast reconstruction. J Plast Reconstr Aesthet Surg, 2020, 73(3): 494-500.
15. 周鑫, 鄒永根, 唐林, 等. 攜帶雙側腹壁淺動脈的下腹壁聯體皮瓣修復足踝大面積軟組織缺損. 中國修復重建外科雜志, 2021, 35(11): 1467-1471.
16. Wang D, Gao T, Liu L, et al. Thin superficial inferior epigastric artery perforator flap for reconstruction of the tongue. Br J Oral Maxillofac Surg, 2020, 58(8): 992-996.
17. Qiao X, Li C, Liu H, et al. Reconstruction of parotid duct defect with autologous vein graft and vascular coupler after buccal mucosa cancer resection. J Stomatol Oral Maxillofac Surg, 2021, 122(6): 608-611.
18. Bakshi J, Goyal AK, Saini J. Quality of life in oral cancer patients following surgical excision and flap reconstruction. J Maxillofac Oral Surg, 2022, 21(2): 326-331.

Chinese Journal of Reparative and Reconstructive Surgery

Application of folded transverse superficial epigastric artery perforator flap for large penetrating defect after buccal carcinoma resection

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