摘要
目的探讨较大眼睑黄色瘤切除后的修复方法及效果。方法眼睑黄色瘤18例31只眼,切除后的缺损面积为横径8-25mm、垂直径5-16mm。根据创面的大小、局部情况及患者的要求,采用直接缝合闭合创面的8只眼,Mercedes皮瓣修复较大黄色瘤切除后的眼睑缺损19只眼,瘤体切除菱形皮瓣转移上睑松弛矫正术同步进行的4只眼。结果所有伤口均一期愈合,皮瓣成活,瘢痕不明显。Mercedes皮瓣修复术后内眦处皱襞自然,无牵拉感,菱形皮瓣平整,眼睑外观形态良好。随访6个月-6年,18例患者眼睑黄色瘤无复发。结论垂直径小于5mm的创面可直接缝合;Mercedes皮瓣设计简单灵活,操作容易,损伤小恢复快,适合各类上睑黄色瘤切除后创面的修复。
Objective To investigate a novel technique for reconstructing shallow defects of the upper eyelid after excision of xanthelasma. Methods Eighteen patients（31 eyes） were operated for the reconstruction of upper eyelid defects after excision of eyelid xanthelasma. The eyelid tumor was excised surgically until clear margins were obtained. Eyelid defects ranged from 8 to 25 mm horizontally and 5 to 16 mm vertically. According to the size, shape, location of eyelid defect and patient＇s requirement, several procedures were available to repair upper eyelid defects. Direct linear closure was performed in 8 eyes. The anterior lamella defect was reconstructed using Mercedes flaps in 19 eyes. The other 4 eyes were treated in a conventional manner rhomboid flaps. Results The flaps were viable without total or partial necrosis in all patients. No patient required surgical revision. The oncologic result was good, and no recurrence was noted. A stable eyelid margin with good aesthetic appearance was achieved in the patients reconstructed by Mercedes flaps. Conclusion Eyelid defects ranged less than 5 mm vertically can be treated by direct linear closure. Mercedes flap is an effective technique for reconstruction of all types of defect after excision of eyelid xanthelasma. The advantages of this approach are simplicity, utilization of preserved tissue, and avoidance of the morbidity associated with more complex orocedures.
出处
《江苏医药》
CAS
CSCD
北大核心
2012年第21期2526-2528,2637,共3页
Jiangsu Medical Journal
基金
江苏高校优势学科建设工程资助项目(JX10231801)
