皮下组织蒂推进皮瓣在面部皮肤软组织缺损修复中应用.doc

皮下组织蒂推进皮瓣在面部皮肤软组织缺损修复中应用[摘要]目的：探讨皮下组织蒂推进皮瓣修复面部皮肤软组织缺损的方法。方法：在拟修复区域旁顺皮纹方向设计近似三角形皮瓣，底边位于近缺损侧。于三角形皮瓣两腰切开皮肤，向下潜行分离皮下组织，形成皮下组织蒂皮瓣，向缺损侧推进，修复面部皮肤软组织缺损。结果:应用皮下组织蒂推进皮瓣修复面部皮肤软组织缺损25例，切口Ⅰ期愈合，形态、质地好，瘢痕不明显。结论:皮下组织蒂推进皮瓣修复面部皮肤软组织缺损，效果确定，操作简单，是修复面部小创面较好的方法之一。 [关键词]皮下组织蒂皮瓣；面部；皮肤软组织缺损 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）05-02 The application of subcutaneous tissue pedicle advanced skin flap in face cutaneous deficiency repair CHEN Jian-jun,ZENG Tian-qing,LI Wen-heng （Department of Plastic Aesthetic Surgery, Integrated Traditional and Western Medicine Orthopedics Hospital of Guigang, Guigang 537100, Guangxi,China） Abstract:ObjectiveTo approach the method of subcutaneous tissue pedicle advanced skin flap in cutaneous deficiency repair of face.MethodsFollowing the dermatoglyph, we had designed a skin flap that similar to triangle beside the area where to be repaired, the bottom of this triangle located near the defected area.To cut the skin open at the two waists of the triangle firstly. Then separate the subcutaneous tissue downwards and outwards to form a subcutaneous pedicle skin flap. Finally, performe the advancement ofsubcutaneous pedicle flap towards the defected area to repair cutaneous deficiency of face.ResultsTwenty-five cases of face cutaneous deficiency had been repaired by such method. All the flaps survived with primary healing and the cosmetic results were satisfactory.ConclusionIt is a safe and reliable method to apply the subcutaneous tissue pedicle advanced skin flap in repairing face cutaneous deficiency. Key words: subcutaneous tissue pedicle flap; face; cutaneous deficiency 面部病变切除后的皮肤软组织缺损，若处理不当，会影响面部形象，给患者造成心理压力，手术不仅要切除病灶还应考虑面容恢复问题。我科自 2004年10月～2006年10月以皮下组织蒂推进皮瓣修复面部皮肤软组织缺损25例，取得了较满意的疗效。 1临床资料 本组共25例，其中男7例，女18例。年龄37～83岁，平均43岁。面部皮肤软组织缺损平均面积1.8cm×2.5cm。皮肤缺损原因：瘢痕14例，色素痣8例，基底细胞癌3例。手术部位：面颊部12例，鼻背部2例，唇部5例，鼻唇沟部6 例。 2手术方法 在局部浸润麻醉下，瘢痕、色素痣距边缘1～2mm切开皮肤直达深筋膜，切除病变组织；基底细胞癌距边缘5mm整体切除病变组织，手术中送快速冰冻病理报告证实切缘及基底部无癌细胞，遗留缺损皆近似于圆形。设计单个近似三角形皮瓣与皮损面积