局部皮瓣在面部软组织缺损美容修复中的应用
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摘要
目的探讨局部皮瓣美容修复面部皮肤软组织缺损的临床效果。方法自2016年5月至2018年6月,收治面部肿物、瘢痕、外伤患者89例,术区缺损面积1.0 cm×1.2 cm～4.5 cm×5.3 cm,以面部美学亚单位分区为原则,根据面部软组织缺损部位、面积等,设计局部皮瓣一期美容修复。结果皮瓣成活良好,切口一期愈合。随访4～24个月,术区无明显瘢痕,肿物无复发,皮瓣与周边皮肤组织厚度、色泽无明显差异,无牵拉及不对称,外观与功能修复效果满意。结论应用局部皮瓣美容修复面部皮肤软组织缺损,损伤范围较小,操作简单,修复皮瓣的厚度、色泽与缺损处相似,瘢痕隐蔽,能够获得较满意的美学与功能修复效果。
Objective To explore the clinical effect of local flaps in the repair of defects of the facial skin and soft tissues. Methods From May 2016 to June 2018, 89 patients with tumors, scars, or trauma were treated in our department. The defect areas ranged from1.0 cm×1.2 cm to 4.5 cm×5.3 cm. Based on the principle of subunit division of facial aesthetics, the local flap was designed for one-stage repair, according to the region of the defect and the area of the facial skin and soft tissue requiring treatment. Results All flaps survived well and incisions healed at stage I. All patients were followed up from 4 to 24 months. There were no obvious scars or recurrence of tumors in the operative sites. There was no significant difference in thickness or color between the flaps and the peripheral skin. No traction or asymmetry occurred. The appearance of the repair and restoration of function was satisfactory. Conclusion The application of local flaps in the repair of defects of facial skin and soft tissue causes minimal damage and is a simple procedure. The thickness and color of the flaps was similar to the peripheral skin of the defect. The scar was hidden and satisfactory restoration of function and aesthetic appearance can be obtained.
Objective To explore the clinical effect of local flaps in the repair of defects of the facial skin and soft tissues. Methods From May 2016 to June 2018, 89 patients with tumors, scars, or trauma were treated in our department. The defect areas ranged from1.0 cm×1.2 cm to 4.5 cm×5.3 cm. Based on the principle of subunit division of facial aesthetics, the local flap was designed for one-stage repair, according to the region of the defect and the area of the facial skin and soft tissue requiring treatment. Results All flaps survived well and incisions healed at stage I. All patients were followed up from 4 to 24 months. There were no obvious scars or recurrence of tumors in the operative sites. There was no significant difference in thickness or color between the flaps and the peripheral skin. No traction or asymmetry occurred. The appearance of the repair and restoration of function was satisfactory. Conclusion The application of local flaps in the repair of defects of facial skin and soft tissue causes minimal damage and is a simple procedure. The thickness and color of the flaps was similar to the peripheral skin of the defect. The scar was hidden and satisfactory restoration of function and aesthetic appearance can be obtained.
引文
[1] LEE D M, BAE Y C, NAM S B, et al. Reconstruction of large facial defects via excision of skin cancer using two or more regional flaps[J]. Arch Plast Surg, 2017,44(4):319-323.
[2] WUSIMAN P, TUERXUN J, LING W, et al. Middle and lower face soft tissue reconstruction:a 10-year retrospective study[J]. Indian J Otolaryngol Head Neck Surg, 2016,68(3):307-313.
[3] EBRAHIMI A, ASHAYERI M, RASOULI H R. Rasouli, comparison of local flaps and skin grafts to repair cheek skin defects[J].J Cutan Aesthet Surg, 2015,8(2):92-96.
[4]刘萍,刘毅,李霞,等.面部美学分区及其在脂肪颗粒注射面部年轻化中的应用[J].中华医学美学美容杂志, 2015,21(5):273-276.
[5] MENICK F J. Defects of the nose, lip, and cheek:rebuilding the composite defect[J]. Plast Reconstr Surg, 2007,120(4):887-898.
[6] MEAIKE J D, DICKEY R M, KILLION E. Facial skin cancer reconstruction[J]. Semin Plast Surg, 2016,30(3):108-121.
[7]孙洋,邵英,李甜,等.带轴心血管的鼻唇沟皮瓣修复多个亚单位鼻缺损一例[J].中国修复重建外科杂志, 2017,31(2):256.
[8] EBRAHIMI A, KAZEMI H M, NEJADSARVARI N. Experience with esthetic reconstruction of complex facial soft tissue trauma:application of the pulsed dye laser[J]. Trauma Mon, 2014,19(3):e16220.
[9] DOLEN U C, BALTU Y, AYDIN O. Subunit reconstruction of mid-facial defects with free style facial perforator flaps[J]. J Craniofac Surg, 2018,29(6):1574-1577.
[10] PANTALENA L, BORDEAUX J S. Reconstruction of a multi-subu nit defect on the lip, nose, and cheek[J]. Dermatol Surg, 2017,43(2):293-296.
[11]敖胤杰,章宏伟,史京萍.亚单位原则设计鼻唇沟皮瓣修复上唇缺损一例报道[J].中国美容整形外科杂志, 2017,28(4):251-252.
[12]袁志明,林泽旭,吴晓红.鼻唇沟皮下蒂皮瓣隧道转移法修复上唇缺损38例[J].中国美容整形外科杂志, 2015,26(12):715-717.
[13]张杨,朱浩.眼轮匝肌蒂岛状肌皮瓣修复邻近皮肤软组织缺损[J].中华医学美学美容杂志, 2013,19(4):301-302.
[2] WUSIMAN P, TUERXUN J, LING W, et al. Middle and lower face soft tissue reconstruction:a 10-year retrospective study[J]. Indian J Otolaryngol Head Neck Surg, 2016,68(3):307-313.
[3] EBRAHIMI A, ASHAYERI M, RASOULI H R. Rasouli, comparison of local flaps and skin grafts to repair cheek skin defects[J].J Cutan Aesthet Surg, 2015,8(2):92-96.
[4]刘萍,刘毅,李霞,等.面部美学分区及其在脂肪颗粒注射面部年轻化中的应用[J].中华医学美学美容杂志, 2015,21(5):273-276.
[5] MENICK F J. Defects of the nose, lip, and cheek:rebuilding the composite defect[J]. Plast Reconstr Surg, 2007,120(4):887-898.
[6] MEAIKE J D, DICKEY R M, KILLION E. Facial skin cancer reconstruction[J]. Semin Plast Surg, 2016,30(3):108-121.
[7]孙洋,邵英,李甜,等.带轴心血管的鼻唇沟皮瓣修复多个亚单位鼻缺损一例[J].中国修复重建外科杂志, 2017,31(2):256.
[8] EBRAHIMI A, KAZEMI H M, NEJADSARVARI N. Experience with esthetic reconstruction of complex facial soft tissue trauma:application of the pulsed dye laser[J]. Trauma Mon, 2014,19(3):e16220.
[9] DOLEN U C, BALTU Y, AYDIN O. Subunit reconstruction of mid-facial defects with free style facial perforator flaps[J]. J Craniofac Surg, 2018,29(6):1574-1577.
[10] PANTALENA L, BORDEAUX J S. Reconstruction of a multi-subu nit defect on the lip, nose, and cheek[J]. Dermatol Surg, 2017,43(2):293-296.
[11]敖胤杰,章宏伟,史京萍.亚单位原则设计鼻唇沟皮瓣修复上唇缺损一例报道[J].中国美容整形外科杂志, 2017,28(4):251-252.
[12]袁志明,林泽旭,吴晓红.鼻唇沟皮下蒂皮瓣隧道转移法修复上唇缺损38例[J].中国美容整形外科杂志, 2015,26(12):715-717.
[13]张杨,朱浩.眼轮匝肌蒂岛状肌皮瓣修复邻近皮肤软组织缺损[J].中华医学美学美容杂志, 2013,19(4):301-302.