真皮脂肪移植修复面部凹陷性缺损
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摘要
目的:探索真皮脂肪移植整复面部凹陷的方法,评价其临床效果并探讨并发症的防治。方法:选择隐蔽切口入路切开供区皮肤至皮下脂肪层,切除表皮后按需要的厚度适当切取真皮脂肪组织,按受区形状修剪重叠,用美容导引针将真皮脂肪组织固定于受区,放置引流后局部加压包扎固定。结果:本组共11例患者,1例患者因切取瘢痕组织再次补填移植物未存活,取出植入物后改用其他材料修复,其余面部凹陷性组织缺损充填术后均一期愈合,近期有效率为90.9%(10/11);随访2年,其中2例因填充量不足经脂肪颗粒注射补充修整,其余病例都获得满意的治疗效果,远期有效率为72.7%(8/11);治疗期间未发生其他并发症。结论:真皮脂肪复合移植是矫正面部凹陷性组织缺损相对安全有效的治疗手段。
Objective To investigate a clinical method to repair facial depression, and to evaluate the effect and the complications. Methods We cut the donor skin to the subcutaneous fat layer using the concealed incision approach. After excising the epidermis, cut the dermal-fat tissue according to the required thickness, trim the overlap according to the shape of the receiving area, and fix the dermal-fat graft in the receiving area with guide needle. After the drainage, the local pressure bandage is fixed. Results A total of 11 patients were treatde 10 of 11 patients were recovered at the first stage. The graft in one patient failed to survive and was replaced with other artificial materials. The short-term effective rate was 90.9%(10/11). After 24 months following-up, excepting that 2 patients were refilled with injection of free fat particles because of the insufficiency of the dermal-fat graft, all other patients obtained satisfied results. The long-term effective rate was 72.7%(8/11). Conclusion Implantation of dermal-fat is an effective and safe method for the repairation of facial depression.
Objective To investigate a clinical method to repair facial depression, and to evaluate the effect and the complications. Methods We cut the donor skin to the subcutaneous fat layer using the concealed incision approach. After excising the epidermis, cut the dermal-fat tissue according to the required thickness, trim the overlap according to the shape of the receiving area, and fix the dermal-fat graft in the receiving area with guide needle. After the drainage, the local pressure bandage is fixed. Results A total of 11 patients were treatde 10 of 11 patients were recovered at the first stage. The graft in one patient failed to survive and was replaced with other artificial materials. The short-term effective rate was 90.9%(10/11). After 24 months following-up, excepting that 2 patients were refilled with injection of free fat particles because of the insufficiency of the dermal-fat graft, all other patients obtained satisfied results. The long-term effective rate was 72.7%(8/11). Conclusion Implantation of dermal-fat is an effective and safe method for the repairation of facial depression.
引文
[1]张卓然.自体脂肪颗粒注射移植在面部凹陷及轻度半侧颜面萎缩症的临床应用[J].中国美容医学,2017,26(7):22-24.
[2]Xu L,Zhao M,Yang Z,et al.Modified penile augmentation by dermal-fat graft in post-hypospadias adults[J].Aesthetic Plast Surg,2016,40(1):120-129.
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[6]郭家平,王翔.游离皮瓣移植术对口腔颌面部肿瘤切除术后缺损的修复研究[J].实用癌症杂志,2016,31(6):915-917.
[7]杨其峰,黎冻,莫海雁,等.精微自体脂肪颗粒移植填充面部年轻化的临床效果[J].中华医学美学美容杂志,2017,23(1):4-6.
[8]盖红宇.富血小板血浆结合自体脂肪移植在面部凹陷填充中的应用[J].中国美容医学,2018,27(1):16-19.
[9]李荣兴,叶清爱,黎秋生,等.富血小板血浆结合自体脂肪移植在面部凹陷填充中的应用及安全性分析[J].中国医疗美容,2018,8(11):4-8.
[10]朱旭冉,刘林嶓,李广帅,等.颗粒脂肪联合PRP及Nanofat治疗面部凹陷的疗效观察[J].中国美容医学,2018,27(12):31-33.
[11]Guo J,Widgerow AD,Banyard D,et al.Strategic sequences in fat graft survival[J].Ann Plast Surg,2015,74(3):376-382.
[12]谭青,董冰松,熊柯.自体游离真皮脂肪瓣移植在眼睑凹陷畸形中的应用[J].中国美容医学,2016,25(5):6-8.
[13]涂晓宇,张建文,刘林嶓.自体真皮脂肪游离移植在局部凹陷畸形矫治中的应用[J].中国美容医学,2017,26(2):28-30.
[14]贺小洁,姜南,申丽,等.改良式聚四氟乙烯假体隆鼻术的疗效观察[J].中国修复重建外科杂志,2016,30(8):930-934.
[15]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:326.
[16]Agostini T,Spinelli G,Marino G,et al.Esthetic restoration in progressive hemifacial atrophy(Romberg disease):structural fat graftingversus local/free flaps[J].J Craniofac Surg,2014,25(3):783-787.
[17]袁凯平,萧艳珊,谢广中.真皮脂肪瓣和脱细胞真皮基质修复面部凹陷性瘢痕的对比研究[J].现代诊断与治疗,2015,26(12):2811-2812.
[2]Xu L,Zhao M,Yang Z,et al.Modified penile augmentation by dermal-fat graft in post-hypospadias adults[J].Aesthetic Plast Surg,2016,40(1):120-129.
[3]Muresan C,Brownstein GM,Shureih SF.Abdominoplasty-derived dermal-fat graft augmentation gluteoplasty[J].Aesthet Surg J,2014,34(8):1234-1243.
[4]谢芸,鲁峰,刘宏伟,等.自体脂肪移植在整形与修复重建外科领域应用的指南[J].中国修复重建外科杂志,2016,30(7):793-798.
[5]Pallua N,Baroncini A,Alharbi Z,et al.Improvement of facial scar appearance and microcirculation by autologous lipofilling[J].J Plast Reconstr Aesthet Surg,2014,67(8):1033-1037.
[6]郭家平,王翔.游离皮瓣移植术对口腔颌面部肿瘤切除术后缺损的修复研究[J].实用癌症杂志,2016,31(6):915-917.
[7]杨其峰,黎冻,莫海雁,等.精微自体脂肪颗粒移植填充面部年轻化的临床效果[J].中华医学美学美容杂志,2017,23(1):4-6.
[8]盖红宇.富血小板血浆结合自体脂肪移植在面部凹陷填充中的应用[J].中国美容医学,2018,27(1):16-19.
[9]李荣兴,叶清爱,黎秋生,等.富血小板血浆结合自体脂肪移植在面部凹陷填充中的应用及安全性分析[J].中国医疗美容,2018,8(11):4-8.
[10]朱旭冉,刘林嶓,李广帅,等.颗粒脂肪联合PRP及Nanofat治疗面部凹陷的疗效观察[J].中国美容医学,2018,27(12):31-33.
[11]Guo J,Widgerow AD,Banyard D,et al.Strategic sequences in fat graft survival[J].Ann Plast Surg,2015,74(3):376-382.
[12]谭青,董冰松,熊柯.自体游离真皮脂肪瓣移植在眼睑凹陷畸形中的应用[J].中国美容医学,2016,25(5):6-8.
[13]涂晓宇,张建文,刘林嶓.自体真皮脂肪游离移植在局部凹陷畸形矫治中的应用[J].中国美容医学,2017,26(2):28-30.
[14]贺小洁,姜南,申丽,等.改良式聚四氟乙烯假体隆鼻术的疗效观察[J].中国修复重建外科杂志,2016,30(8):930-934.
[15]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:326.
[16]Agostini T,Spinelli G,Marino G,et al.Esthetic restoration in progressive hemifacial atrophy(Romberg disease):structural fat graftingversus local/free flaps[J].J Craniofac Surg,2014,25(3):783-787.
[17]袁凯平,萧艳珊,谢广中.真皮脂肪瓣和脱细胞真皮基质修复面部凹陷性瘢痕的对比研究[J].现代诊断与治疗,2015,26(12):2811-2812.