【摘要】 目的：探讨近心侧阶梯状切取双全厚皮片在前臂皮瓣供区创面修复中的可行性及临床效果。方法：选取2023年1月—2024年12月南充市中心医院口腔颌面外科12例口腔癌术后需同期行前臂皮瓣移植修复的患者，在制备前臂皮瓣时，于皮瓣近心侧采用阶梯形切口设计切取2个全厚皮片，体外拼接后移植修复供区缺损。术后随访3～6个月，评估供区愈合情况、并发症发生率及患者美学与功能满意度。结果：12例患者均成功制备前臂皮瓣并切取双份全厚皮片，体外拼接后移植修复供区，11例供区实现一期愈合，前臂皮瓣全部成活。术后1例皮片因供区缝合张力过大发生坏死，经换药后瘢痕愈合；其余11例皮片完全成活，供区瘢痕细小，腕关节屈伸功能不受限，患者满意度较高。结论：前臂皮瓣近心侧阶梯状切取全厚皮片拼接修复供区，可避免第三术区损伤，减少手术创伤，实现供区微创修复，是前臂皮瓣供区缺损修复的可行方案。更多还原

【Abstract】 PURPOSE: To investigate the feasibility and evaluate the clinical effect of double thickness skin graft obtained by proximal cardiac step incision in repairing the wound of forearm flap donor site. METHODS: From January2023 to December 2024, 12 patients with oral cancer who required simultaneous forearm flap transplantation after surgery were enrolled in Nanchong Central Hospital. During flap preparation, two full-thickness skin grafts were harvested from the proximal side of the forearm flap using a stepped incision design. After in vitro splicing, the grafts were transplanted to repair the donor site defect. Postoperative follow-up lasted 3-6 months to evaluate donor site healing, complications, and patient satisfaction with aesthetics and function. RESULTS: All 12 patients successfully underwent forearm flap preparation, double full-thickness skin graft harvesting, and in vitro splicing. The donor sites of 11 cases achieved primary closure, and all forearm flaps survived. One skin graft developed necrosis due to excessive suture tension, which healed with scarring after dressing changes; the remaining 11 skin grafts survived completely, with small donor site scars,unimpaired wrist flexion-extension function, and high patient satisfaction. CONCLUSIONS: Stepwise harvesting of fullthickness skin grafts from the proximal forearm flap and splicing for donor site repair can avoid injury to the third surgical area, reduce surgical trauma, and achieve minimally invasive repair of the donor site. It is a feasible solution for the repair of donor site defects of the forearm flap.更多还原