摘要
目的探讨应用以颞浅血管顶支为蒂的头皮岛状瓣再造鬓角的可行性和临床疗效。方法 2012年2月—2015年4月,收治7例拟再造鬓角患者。男3例,女4例;年龄4~44岁,平均15岁。烧烫伤后瘢痕3例,外伤瘢痕1例,血管瘤同位素放射治疗后瘢痕1例,先天性色素痣2例。鬓角缺损范围为5.0 cm×3.5 cm^16.0 cm×10.0 cm。一期根据鬓角区皮肤软组织缺损大小,在包含颞浅血管顶支的正常头皮组织下埋置皮肤软组织扩张器,术后定期注水扩张;一期术后3~6个月,待扩张头皮达到预期修复所需组织量时,二期手术取出扩张器,切取以颞浅血管顶支为蒂的头皮岛状瓣修复鬓角软组织缺损,皮瓣范围为8 cm×3 cm^17 cm×11 cm。供区直接拉拢缝合。结果术后皮瓣均顺利成活,受区创面及供区切口均Ⅰ期愈合。患者均获随访,随访时间1~36个月,平均9.8个月。再造鬓角形态、毛发密度、毛发生长方向与对侧正常鬓角相似。1例术后皮瓣毛发超出原有发际线,经激光脱毛处理外观满意。结论应用以颞浅血管顶支为蒂的扩张头皮岛状瓣修复鬓角区皮肤软组织缺损,再造鬓角外观与对侧正常鬓角相似,是一种有效修复方法。
Objective To explore the feasibility and effectiveness of sideburn reconstruction using the expanded island scalp flap based on the parietal branch of the superficial temporal vessel. Methods Between February 2012 and April 2015, 7 patients underwent sideburn reconstruction. There were 3 males and 4 females with an average age of15 years（range, 4-44 years）. The etiologies included burn injury in 3 cases, trauma in 1 case, radiation therapy in 1 case,and congenital melanocytic nevus in 2 cases. The size of the sideburn defects ranged from 5.0 cm×3.5 cm to 16.0 cm×10.0 cm. At the first-stage, according to the sideburn defect, a tissue expander of the appropriate size was inserted beneath the superficial temporal fascia which containing the parietal branch of the superficial temporal vessel. Postoperatively,regular saline injection was commenced. After 3-6 months of the first-stage surgery, the expander was adequately inflated.While the second-stage surgery was performed, the lesion was excised and the tissue expander removed. The expanded island scalp flap based on the parietal branch of the superficial temporal vessel was harvested and advanced towards the defect of the sideburn according to the contralateral normal one, and the size of flap ranged from 8 cm×3 cm to 17 cm×11 cm.The donor site was closed primarily. Results All flaps survived and the wound and donor sites were healed primarily without any complication. All patients were followed up 1-36 months（mean, 9.8 months）. The profile, hair density, and hair direction of the new sideburn were similar to the contralateral sideburn. In 1 patient, the reconstructed sideburn was a little larger than the contralateral normal one. After laser hair removal, the patient was satisfied with the appearance.Conclusion The expanded island scalp flap based on the parietal branch of the superficial temporal vessel provides an e ffective option for the sideburn reconstruction, which presents with the similar appearance to the contralateral one.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2017年第11期1358-1362,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
鬓角再造
扩张皮瓣
颞浅血管
头皮岛状瓣
顶支
Sideburn reconstruction
expanded flap
superficial temporal vessel
island scalp flap
parietal branch
