鼻唇沟皮瓣修复鼻部皮肤软组织缺损的临床观察
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摘要
目的:探讨鼻唇沟皮瓣修复鼻部皮肤软组织缺损的方法。方法:选取2015年10月-2018年4月收治的36例鼻部皮肤软组织缺损患者,皮肤软组织缺损面积(2.68±2.23)cm~2。按鼻部亚单位和鼻部皮肤软组织缺损的形状、大小、深度及部位,分别在鼻唇沟设计"风筝"皮瓣(9例)、改良菱形皮瓣(19例)、旋转皮瓣(6例)、局部皮瓣(2例)修复,全部创面与皮瓣匹配良好。结果:36例患者中有29例评价为优;5例为良;2例为一般;0例为差,总有效率为94.4%。本组病例皮瓣100%成活,伤口均一期愈合,术后随访3个月～1年,切口瘢痕不明显,外形良好,患者对面部形态及美学效果满意,肿瘤患者未发现局部复发。结论:应用鼻唇沟皮瓣修复鼻部皮肤软组织缺损方法简单,效果满意。
Objective To explore the method of repairing soft tissue defect of nasal skin with nasolabial groove skin flap. Methods From October 2015 to April 2018, 36 patients with nasal skin and soft tissue defect were selected for treatment, with skin and soft tissue defect area(2.68±2.23)cm~2. According to the shape, size, depth and location of skin and soft tissue defects in the subunit of the nose and nose, "kite" skin flap(9 cases), improved diamond skin flap(19 cases), rotating skin flap(6 cases) and partial skin flap(2 cases) were designed in the nasolabial groove respectively for repair. Results Of the 36 patients, 29 were evaluated as excellent. 5 patients were assessed as good. 2 patients were evaluated as general. None of the patients were evaluated as poor, with a total effective rate of 94.4%. In this group of 36 patients, the skin flap was 100% viable, and the wound healed in stage I. The postoperative follow-up period was 3 months to 1 year. The incision scar was not obvious and the appearance was good. Conclusion Application of nasolabial groove skin flap to repair nasal skin soft tissue defect method is simple and satisfactory.
Objective To explore the method of repairing soft tissue defect of nasal skin with nasolabial groove skin flap. Methods From October 2015 to April 2018, 36 patients with nasal skin and soft tissue defect were selected for treatment, with skin and soft tissue defect area(2.68±2.23)cm~2. According to the shape, size, depth and location of skin and soft tissue defects in the subunit of the nose and nose, "kite" skin flap(9 cases), improved diamond skin flap(19 cases), rotating skin flap(6 cases) and partial skin flap(2 cases) were designed in the nasolabial groove respectively for repair. Results Of the 36 patients, 29 were evaluated as excellent. 5 patients were assessed as good. 2 patients were evaluated as general. None of the patients were evaluated as poor, with a total effective rate of 94.4%. In this group of 36 patients, the skin flap was 100% viable, and the wound healed in stage I. The postoperative follow-up period was 3 months to 1 year. The incision scar was not obvious and the appearance was good. Conclusion Application of nasolabial groove skin flap to repair nasal skin soft tissue defect method is simple and satisfactory.
引文
[1]薛春雨,邢新,郭伶俐,等.鼻唇沟皮瓣的分类及在鼻部创面修复中的应用[J].中国美容整形外科杂志,2010,21(1):20-23.
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[4]张斌,刘积东,李乔,等.局部皮瓣修复鼻部皮肤恶性小肿瘤术后缺损54例[J].中华皮肤科杂志,2010,43(6):405-407.
[5]牟世伟,高金娥.额部双蒂皮瓣修复额面部软组织缺陷[J].内蒙古医科大学学报,2016,38(5):398-400.
[6]赵思山,刘晓芳,徐春亭,等.眼睑组织缺损26例修复重建效果分析[J].人民军医,2017,60(2):182-183.
[7]柏青,祝闽辉,叶祥柏.“双风筝”皮瓣在眼睑前层色素痣切除后创面修复中的应用[J].军事医学,2017,41(6):546-547.
[8]武崇高.30例眼睑肿瘤切除二期修复[J].中外医学研究,2016,14(35):159-160.
[9]史俊虎,刘杉,白萍,等.自体游离硬颚黏膜重建眼睑的效果观察[J].中国组织工程研究,2017,21(12):1921-1925.
[10]李明,刘少倩,陈碾,等.自体组织再造睑板联合颞区皮瓣修复下眼睑全层缺损[J].中南大学学报(医学版),2017,42(6):662-666.
[11]刘毅,张诚,张鲜英,等.皮肤恶性肿瘤97例临床分析[J].临床肿瘤学杂志,2002,7(6):427-429.
[12]陈剑名,杨镇生.应用改良A-T皮瓣修复颜面部皮肤缺损[J].中国美容医学,2016,25(7):6-9.
[13]朱喆辰,侯祚琼,王鸣,等.耳甲腔复合组织联合面部皮瓣修复眼睑全层缺损的应用[J].中国美容整形外科杂志,2017,28(6):352-354.
[14]房林,王佳琦.扩张皮瓣在修复眼睑软组织缺损中的临床应用[J].中国美容医学,2009,18(11):1598-1600.
[15]王毅,鲜小庆.额部扩张皮瓣在修复瘢痕性眼睑外翻中的应用[J].中国美容医学,2013,22(7):726-729.
[2]王大玫.成形外科学讲座(头颈部)[M].昆明:云南人民出版社,1982:534-536.
[3]IraD.Papel.面部整形与重建外科[M].曹谊林,主译.2版.济南:山东科学技术出版社,2004:45-47.
[4]张斌,刘积东,李乔,等.局部皮瓣修复鼻部皮肤恶性小肿瘤术后缺损54例[J].中华皮肤科杂志,2010,43(6):405-407.
[5]牟世伟,高金娥.额部双蒂皮瓣修复额面部软组织缺陷[J].内蒙古医科大学学报,2016,38(5):398-400.
[6]赵思山,刘晓芳,徐春亭,等.眼睑组织缺损26例修复重建效果分析[J].人民军医,2017,60(2):182-183.
[7]柏青,祝闽辉,叶祥柏.“双风筝”皮瓣在眼睑前层色素痣切除后创面修复中的应用[J].军事医学,2017,41(6):546-547.
[8]武崇高.30例眼睑肿瘤切除二期修复[J].中外医学研究,2016,14(35):159-160.
[9]史俊虎,刘杉,白萍,等.自体游离硬颚黏膜重建眼睑的效果观察[J].中国组织工程研究,2017,21(12):1921-1925.
[10]李明,刘少倩,陈碾,等.自体组织再造睑板联合颞区皮瓣修复下眼睑全层缺损[J].中南大学学报(医学版),2017,42(6):662-666.
[11]刘毅,张诚,张鲜英,等.皮肤恶性肿瘤97例临床分析[J].临床肿瘤学杂志,2002,7(6):427-429.
[12]陈剑名,杨镇生.应用改良A-T皮瓣修复颜面部皮肤缺损[J].中国美容医学,2016,25(7):6-9.
[13]朱喆辰,侯祚琼,王鸣,等.耳甲腔复合组织联合面部皮瓣修复眼睑全层缺损的应用[J].中国美容整形外科杂志,2017,28(6):352-354.
[14]房林,王佳琦.扩张皮瓣在修复眼睑软组织缺损中的临床应用[J].中国美容医学,2009,18(11):1598-1600.
[15]王毅,鲜小庆.额部扩张皮瓣在修复瘢痕性眼睑外翻中的应用[J].中国美容医学,2013,22(7):726-729.