中国修复重建外科杂志

中国修复重建外科杂志

接力皮瓣修复耳廓及供瓣区皮肤软组织缺损

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目的 探讨接力皮瓣修复耳廓及供瓣区皮肤软组织缺损的疗效。 方法 2014 年 5 月—2016 年 1 月,收治 10 例耳廓皮肤肿瘤患者。男 4 例,女 6 例;年龄 21~69 岁,平均 35 岁。基底细胞癌 2 例,色素痣 3 例,乳头状瘤 4 例,鲍文病 1 例。术中切除肿物后遗留创面范围为 1.1 cm×1.0 cm~2.3 cm×1.7 cm。用颞浅动脉耳后穿支皮瓣修复耳廓缺损,皮瓣切取范围为 1.5 cm×1.4 cm~2.8 cm×2.0 cm;使用耳后动脉穿支顺行推进皮瓣修复第 1 供瓣区,皮瓣切取范围为 4.0 cm×2.0 cm~7.5 cm×3.0 cm,第 2 供瓣区创面直接拉拢缝合。 结果 术后皮瓣均顺利成活,供、受区创面均Ⅰ期愈合。患者均获随访,随访时间 10~28 个月,平均 14.2 个月。重建耳廓形态满意,肿瘤无复发。皮瓣外形、色泽、质地和厚度与受区基本一致,瘢痕不明显,无牵拉畸形,感觉无明显异常。 结论 接力皮瓣血供可靠,手术操作简便,供区隐蔽,是修复耳廓及供瓣区皮肤软组织缺损的较好选择。

Objective To investigate the effectiveness of relay flap on repairing skin and soft tissue defect of auricle and donor site. Methods Between May 2014 and January 2016, 10 patients with auricular tumor were repaired by relay flap. There were 4 males and 6 females with an average age of 35 years (range, 21-69 years). There were basal cell carcinoma in 2 cases, pigmented nevus in 3 cases, papilloma in 4 cases, and Bowen’s disease in 1 case. The size of the residual wound after tumor resection ranged from 1.1 cm×1.0 cm to 2.3 cm×1.7 cm. The superficial temporal artery posterior auricular perforator flap was used to repair the auricle defect wound. The size of flap ranged from 1.5 cm×1.4 cm to 2.8 cm×2.0 cm. The first donor site was repaired with the posterior auricular artery perforator propulsive flap. The size of flap ranged from 4.0 cm×2.0 cm to 7.5 cm×3.0 cm. The wound of the second donor site was sutured directly at the first stage. Results All the flaps survived. The donor and recipient sites healed by first intention. The patients were followed up 10-28 months, with an average of 14.2 months. The appearance of reconstructed auricle was satisfactory, and the tumor had no recurrence. The appearance, color, texture, and thickness of the flaps were basically consistent with the recipient site, without obvious scar, traction deformity, or obvious abnormal sensation. Conclusion The relay flap has advantages of reliable blood supply, the simple operation method, the concealed donor site, which is a good choice to repair the skin and soft tissue defect of auricle and donor site.

关键词: 耳廓修复; 接力皮瓣; 耳后动脉; 软组织缺损

Key words: Auricle repair; relay flap; posterior auricular artery; soft tissue defect

引用本文: 常树森, 唐修俊, 魏在荣, 吴必华, 王波, 金文虎, 陈伟, 李海, 张子阳. 接力皮瓣修复耳廓及供瓣区皮肤软组织缺损. 中国修复重建外科杂志, 2019, 33(1): 66-69. doi: 10.7507/1002-1892.201807141 复制

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