Original Article
Effects of anterolateral thigh free flap with fascia lata in repairing dura mater defect after resection of head squamous cell carcinoma
Han Fu, Zheng Zhao, Wang Hongtao, Guan Hao, Ji Peng, Hu Xiaolong, Tong Lin, Zhang Zhi, Chen Qiaohua, Feng Aina, Hu Dahai
Published 2020-03-20
Cite as Chin J Burns, 2020,36(03): 219-223. DOI: 10.3760/cma.j.cn501120-20190505-00222
Abstract
ObjectiveTo evaluate the clinical effects of anterolateral thigh free flap with fascia lata in the repair of dura mater defect after resection of head squamous cell carcinoma.
MethodsFrom June 2016 to June 2018, Xijing Hospital of Air Force Medical University applied the free transplantation of anterolateral thigh flap with fascia lata to repair the dura mater defect of 12 patients with head squamous cell carcinoma, including 9 males and 3 females, aged from 35 to 74 years. The size of scalp soft tissue defects in patients after carcinoma resection ranged from 12 cm×10 cm to 24 cm×21 cm, and the size of dura mater defect of patients ranged from 7 cm×6 cm to 16 cm×14 cm. The size of flap of patients ranged from 14 cm×12 cm to 27 cm×24 cm, and the size of fascia lata ranged from 8 cm×7 cm to 17 cm×15 cm. The superficial temporal artery and middle temporal vein were connected by end to end anastomosis with the first musculocutaneous perforating branch of the descending branch of lateral femoral artery and its accompanying vein. The flap donor area was transplanted with autologous split-thickness skin graft from trunk and fixed with packing. Postoperative survival of flaps and skin grafts was observed. The patients were followed up regularly. The cranial magnetic resonance imaging was performed to observe the recurrence of intracranial tumors and dural integrity, shape of the flap and whether the donor site region was left with significant dysfunction were observed.
ResultsAll the flaps and skin grafts survived well in 12 patients after surgery. Ten patients had primary healing at the edge of the flap suture; 2 patients had local sinus tract formation at the suture site of flap, with a small amount of cerebrospinal fluid leakage, and were recovered after outpatient dressing change. The patients were followed up for 10 to 36 months, and 3 patients with tumors involving in the dura mater sagittal sinus region had postoperative intracranial tumor recurrence. The tumor was resected again. All the patients had good dural integrity. The flaps of all patients were in good shape, and no obvious dysfunction remained in the flap donor site.
ConclusionsFree transplantation of anterolateral thigh flap with fascia lata is an effective and reliable method to repair the dura mater defect following head squamous cell carcinoma resection. It can repair the scalp and dura mater defects caused by the invasion of squamous cell carcinoma and provide possibilities for skull reconstruction.
Key words:
Carcinoma, squamous cell; Fascia lata; Anterolateral thigh flap; Dura mater defects
Contributor Information
Han Fu
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Zheng Zhao
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Wang Hongtao
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Guan Hao
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Ji Peng
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Hu Xiaolong
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Tong Lin
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Zhang Zhi
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Chen Qiaohua
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Feng Aina
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China
Hu Dahai
Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi′an 710032, China