摘要
目的探讨扩张后额部皮瓣修复面中部病损的临床效果。方法2003年1月—2018年12月,笔者单位收治19例面中部病损患者,其中男8例、女11例,年龄为7~52岁。Ⅰ期行扩张术,在患者额部置入1个额定容量为100~170 mL的圆柱形扩张器,注水1~2个月,总注水量为扩张器额定容量2倍左右。Ⅱ期面中部病损切除后创面面积为4 cm×2 cm^9 cm×5 cm,采用以滑车上动脉为蒂或颞浅动脉额支为蒂的额部扩张皮瓣修复面中部病损,患者皮瓣切取面积为5 cm×2 cm^16 cm×6 cm,供区直接拉拢缝合,3周后断蒂。观察并发症发生情况以及皮瓣转移、断蒂后血运情况和术后随访治疗效果。结果本组患者中11例患者皮瓣以滑车上动脉为蒂,8例患者皮瓣以颞浅动脉额支为蒂。术后皮瓣全部成活,无明显并发症发生,皮瓣转移、断蒂后血运良好。12例患者Ⅲ期断蒂术后6~12个月随访,下睑均无外翻,皮瓣外观与周围组织相似、不臃肿。结论扩张后额部皮瓣修复面中部病损,不仅修复了缺损还有效避免了下眼睑外翻,是目前效果较佳的方法。
Objective To explore the clinical effects of expanded forehead flaps in repairing midfacial defects.Methods From January 2003 to December 2018,19 patients with midfacial defects were admitted to our unit,including 8 males and 11 females,aged 7 to 52 years.One cylindrical expander with rated capacity ranged from 100 to 170 mL was placed in the forehead of patients in the first stage of expansion,and the total water injection volume was about 2 times of the rated capacity of the expander during 1 to 2 months.The area of midfacial defects was 4 cm×2 cm to 9 cm×5 cm after resection in the second stage surgery.Expanded forehead flaps with vascular pedicle of supratrochlear vessels or frontal branch of superficial temporal vessels were used to repair the midfacial defects,with flap size ranging from 5 cm×2 cm to 16 cm×6 cm.The donor sites were closed by direct suturing.Three weeks later,the pedicle was divided.The complications,blood supply after flap transfer and pedicle division,and the treatment effects during follow-up were observed.Results Among the patients,flaps of 11 patients had vascular pedicle of supratrochlear vessels;flaps of 8 patients had vascular pedicle of frontal branch of superficial temporal vessels.All the flaps survived with no complications and good blood supply after flap transfer and pedicle division.During the follow-up of 6 to 12 months after the third stage surgery of pedicle division of 12 patients,no lower eyelid ectropion occurred,the appearance of the flaps was similar to the surrounding tissue with no swelling.Conclusions The application of expanded forehead flaps can not only repair the defects but also effectively avoid the complication of lower eyelid ectropion,which is a promising method in repairing midfacial defects.
作者
彭湃
丁健科
刘士强
唐银科
楚菲菲
王占统
董琛
陈淑强
马显杰
Peng Pai;Ding Jianke;Liu Shiqiang;Tang Yinke;Chu Feifei;Wang Zhantong;Dong Chen;Chen Shuqiang;Ma Xianjie(Institute of Plastic Surgery of PLA,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2019年第12期855-858,共4页
Chinese Journal of Burns
基金
国家自然科学基金(81671925)
陕西省重点研发计划(2018ZDXM-SF-081)。
