Clinical application of free flaps which were transplanted to repair the postoperative defects of maxillofacial tumors with the aid of microvascular anastomotic
Objective To investigate the clinical effect of microvascular anastomosis with free tissue flap in the repair of postop-erative defects of maxillofacial tumors.Methods From March 2018 to March 2021,118 patients who suffered from maxillofacial tumors were selected from the Department of Oral and Maxillofacial Surgery in Nanchong Central Hospital the microvascular anastomotic was selected to assist the vascular anastomosis of free tissue flap during the operation,recorded microvascular stapling diameter,the vascu-lar anastomosis time and immediate patency rate after anastomosis,the postoperative survive rates of free tissue flap were evaluated.Fifty-eight forearm flaps,57 anterolateral femoral perforator flaps were included,and 3 fibular flaps were included.Results A total of 118 cases were repaired with free tissue flaps.Totally 234 microvascular anastomotics were used during the operation,233 microvascular anastomotics were used for venous anastomosis(3 patients received single-vein end-to-end anastomosis,while the remaining 115 patients received double-vein end-to-end anastomosis).The time of anastomosis of a single vessel was 3.0-8.0 min,with an average of 5.4 min.One was used for end-to-end arterial anastomosis and lasted 12 min.The immediate patency rates of all vessels after anastomosis with the aid of microvascular anastomats were 100%.Postoperative follow-up showed that 117 of 118 free tissue flaps survived,and 2 cases devel-oped vascular crisis on the second day after surgery.After emergency exploration and rescue,1 flap survived,and the other one was debrid-ed after necrosis,and the pectoralis major myocutaneous flap was used to repair the wound surface.Conclusion The microvascular anas-tomat which is used for vascular anastomosis of free tissue flap in the reconstruction of postoperative defects of maxillofacial tumors can sig-nificantly shorten the time of vascular anastomosis,the operation is simple and fast,and the quality of anastomosis is relatively reliable,so it is an ideal choice for the vascular anastomosis of free tissue flap.
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