中国修复重建外科杂志

中国修复重建外科杂志

改良菱形皮瓣在面部皮肤软组织缺损修复中的应用

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目的探讨改良菱形皮瓣修复面部皮肤软组织缺损的临床效果。方法2016 年 1 月—2018 年 5 月,应用改良菱形皮瓣修复面部皮肤软组织缺损 23 例。男 10 例,女 13 例;年龄 11~72 岁,中位年龄 27 岁。原发肿瘤:色素痣 18 例,基底细胞癌 4 例,鳞状细胞癌 1 例。缺损部位:鼻部 8 例,颊部 4 例,颧部 6 例,额部 2 例,上唇部 3 例;缺损范围 0.8 cm×0.8 cm~3.9 cm×3.9 cm。根据面部肿瘤部位、大小设计正方形病灶切除范围,根据周边组织移动性及皮纹方向,设计角度为 45~60° 的菱形皮瓣供区,无张力旋转修复缺损。结果术后皮瓣均成活,切口均Ⅰ期愈合。23 例患者均获随访,随访时间 3~15 个月,平均 7.3 个月。随访期间肿瘤均无复发,皮瓣颜色、质地与周边组织相似,无明显瘢痕增生,邻近正常组织无牵拉,患者满意度高。结论应用改良菱形皮瓣修复面部圆形肿瘤切除后缺损创面,具有设计灵活、操作简便、创伤小等优点。

ObjectiveTo explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect.MethodsBetween January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years (range, 11-72 years). The primary tumor included pigmented nevus in 18 cases, basal cell carcinoma in 4 cases, and squamous cell carcinoma in 1 case. The defect location was nose in 8 cases, cheek in 4 cases, malar in 6 cases, forehead in 2 cases, and upper lip in 3 cases. The defect ranged from 0.8 cm×0.8 cm to 3.9 cm×3.9 cm. According to the location and size of facial tumors, the resection area of square lesions was designed. According to the mobility of surrounding tissues and the direction of dermatoglyphic lines, the rhomboid flaps with an angle of 45–60° was designed to repair the defect by tension-free rotation.ResultsAll the flaps survived and the incision healed by first intension. All patients were followed up 3-15 months (mean, 7.3 months). During follow-up, no tumor reoccurred; the color and texture of the flaps were similar with surrounding tissue. There was no obvious scar hyperplasia, nor traction of adjacent normal tissues, and patients were satisfied with the appearance.ConclusionThe application of modified rhomboid flaps in repairing facial skin and soft tissue defects caused by resection of round facial tumor has the advantages of flexible design, simple manipulation, and less trauma.

关键词: 改良菱形皮瓣; 面部皮肤缺损; 创面修复; 面部

Key words: Modified rhomboid flap; facial skin defect; wound repair; face

引用本文: 黄娜, 文辉才, 付建华, 黄进军, 廖怀伟, 涂峻, 卢颖洁, 祝愿, 蒯权. 改良菱形皮瓣在面部皮肤软组织缺损修复中的应用. 中国修复重建外科杂志, 2019, 33(2): 207-211. doi: 10.7507/1002-1892.201810020 复制

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