摘要
目的总结采用带双侧颞浅动静脉的额颞部扩张皮瓣修复面颈部大面积瘢痕挛缩的临床经验及体会。方法以本院14例面颈部瘢痕挛缩患者为研究对象。以双侧颞浅动静脉为蒂,于额部置入1枚400-600ml皮肤扩张器,两颞部分别置入50~100ml皮肤扩张器,3-4个月注水达到扩张器容量的2倍,维持一个月后行皮瓣移植术;预留额部皮瓣供发际线重建,切取皮瓣覆盖与面颈部瘢痕松解后区域,重建颌颈角;术后3~4周后行断蒂及蒂部修整。结果本组14例患者,均顺利完成手术,皮瓣扩张时间5~6个月,扩张皮瓣切取面积26cm×9cm^42cm×16cm,术后皮瓣全部存活。其中2例患者皮瓣移植术后发生皮瓣淤血情况。随访6~12个月,皮瓣色泽、质地与面部皮肤相近,过渡自然,无明显臃肿。颌颈角约90°,颈部前屈、后伸、侧屈及旋转均较前明显改善,后伸接近正常。结论带双侧颞浅动静脉的额颞部扩张皮瓣适用于适用于在邻近局部正常组织扩张后仍无法满足修复的面颈部大面积瘢痕挛缩者。
Objective To summarize the clinical experience and experience of repairing large area cicatricial contracture of face and neck with frontotemporal expanded flap with bilateral superficial temporal artery and vein.Methods 14 cases of cicatricial contracture of face and neck were studied A 400-600 ml skin expander was placed in the frontal part and 50-100 ml skin expander was placed in the two temporal parts. The volume of the expander was twice as much as that of the water injection in 3-4 months. The flap was transplanted after one month’s maintenance. The frontal flap was reserved for reconstruction of the donor hair line. The flap was cut to cover the area after loosening the scar on the face and neck to reconstruct the maxillocervical angle. It was broken 3-4 weeks later Pedicel and pedicel dressing.Results All of the 14 patients successfully completed the operation. The flap expanded for 5 to 6 months. The flap area was 26 cm × 9 cm ~ 42 cm × 16 cm. All the flaps survived after the operation. There were 2 cases of congestion of skin flap after skin flap transplantation. Follow up for 6-12 months showed that the color and texture of the flap were similar to that of the facial skin, and the transition was natural without obvious overstaffing. The angle of jaw and neck is about 90 °. The flexion, extension, lateral flexion and rotation of neck are obviously improved, and the extension is close to normal.Conclusion The expanded frontotemporal flap with bilateral superficial temporal artery and vein is suitable for the large area cicatricial contracture of face and neck which can not be repaired after the expansion of adjacent normal tissue.
作者
邵明辰
程鹏
崔彦魁
SHAO Ming-chen;CHENG Peng;CUI Yan-kui(Jiaozuo Second People's Hospital,Henan Province,456000,China)
出处
《中国医疗美容》
2019年第10期49-52,共4页
China Medical Cosmetology
关键词
扩张皮瓣
额颞部
面颈部
瘢痕挛缩
大面积
颞浅动静脉
expanded flap
frontotemporal
face and neck
cicatricial contracture
large area
superficial temporal artery and vein
