[Application of digital 3D imaging technique in flap design before maxillofacial soft tissue reconstruction].

Objective: Using digital technique to design the preoperative flap of oral and maxillofacial soft tissue defect, to instruct the operation and to provide the basis for making the individual femoral flap. Method: We chosed 7 patients with oral and maxillofacial malignancies to undergo thin-line CT scans of lower extremities and analyzed the data of CTA examination to measure the diameter, shape and length of vascular pedicle. Then selected the appropriate perforation as the source of blood supply for flap. The location of perforation was marked on the skin to simulate flap removal range.During the surgery according to the preoperative mark, draw lines and mark flap size. After flap preparation is completed, suture the donor area directly and build in negative pressure drainage tube. Result: All reconstruction of the anterolateral femoral artery descending perforator flap can show the skin, muscle, blood vessels and their adjacent relationship, and according to the size of the defect area, using Mimics 17.0 software simulation to cut flap which should be the same as the defect area. The main perforating branches and trunks of seven skin flaps were consistent with pre-operative examination and all skin flaps survived; the wound surface and the donor were all in stage Ⅰ healing. After operation, patients were followed up for 1-6 months and the form, quality and function of skin flaps all recovered well. Conclusion: The location of lateral femoral circumflex artery descending limb and perforating branch were accurately located by digital technique three-dimensional reconstruction technology, showing the spatial relationship among skin, muscle, blood vessels and bones. By combining with Mimics 17.0 software, it can achieve three-dimensional and accurate design of anterolateral thigh flap, reduce the donor injury and improve the successful rate of skin flap.