구강암 환자의 재건술
Reconstruction of oral cancer patients
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초록
구강암을 제거 하고 나면 떼어낸 조직의 종류와 제거된 연조직과 경조직의 범위와 크기에 따라 다양한재건법이 사용된다. T1 크기(2㎝ 이하)의 조직을 제거 한 경우에는 일차 봉합법이나 간단한 부분층 피부이식을 사용하여 창상의 치유를 도모하기도 하지만T2이상(2㎝ 이상) 크기의 종양을 제거하고 나면 일차봉합이 어려워 신체의 다른 부위에서 조직을 가져와서재건을 하게 된다. 이러한 이식 조직을 피판(flap)이라고 하며 피판은 해부학적 위치, 혈행의 종류, 포함한 조직의 범위에 따라 다양하게 분류 될 수 있다. 본논문에서는 피판의 종류를 구분해 보고 구강내 연조직재건에 가장 많이 사용되는 전완요피판과 경조직과 연조직을 동시에 재건 할 수 있는 비골피판 재건에 대하여 증례를 통하여 알아보고 유용성과 한계점을 파악하고자 하였다1, 2).
Abstract
Reconstruction after ablative oral cancer surgery is challenging mission. Soft tissue and hard tissue could be resected in case of advanced oral cancer. The final goal of oral reconstruction is to gain normal swallowing, chewing and speech. Nowadays, free flap reconstruction after oral cancer resection is more popular than pedicled flap. Microsurgical reconstruction with free flap could be used effectively in complicated cases of oral cavity defect. However, complications could be happened. So not only meticulous preoperative study about the extent of defects but also the donor site dressing after surgery were performed to prevent postoperative complication. The most favorite free flap for soft tissue reconstruction is radial forearm flap. It has a lot of advantages such as pliable, hairless, reliable vessels, appropriate diameter of radial artery and diverse flap design. And the most popular free flap for jaw reconstruction is free fibular flap. In this article, we report the classification of flap for reconstruction and reveal the pits and falls of radial forearm free flap and free fibular flap. .
참고문헌 (16)
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