鼻唇沟皮下组织蒂皮瓣在上唇缺损修复中应用.docVIP

鼻唇沟皮下组织蒂皮瓣在上唇缺损修复中应用[摘要]目的：介绍鼻唇沟皮下组织蒂皮瓣在上唇缺损修复中的应用。方法：2006年6月～2010年4月间，应用鼻唇沟皮下组织蒂皮瓣修复上唇缺损31例。于缺损邻近部位设计鼻唇沟皮下组织蒂皮瓣，按设计线切开皮肤，向下及周围潜行分离形成皮瓣，滑行或旋转修复上唇缺损。结果：应用此法修复上唇缺损31例，切口均I期愈合，皮瓣全部成活，术区平整，无“猫耳”畸形，面部形态满意,远期瘢痕不明显。结论：鼻唇沟皮下组织蒂皮瓣修复上唇缺损，手术效果肯定，能达到良好的美学效果，是一种较理想的修复方法。 [关键词]鼻唇沟皮瓣；皮下组织蒂皮瓣；上唇缺损；修复 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）02-0185-03 Application of subcutaneous pedicle nasolabial flap in upper lip defects repair SHEN Di,FAN Xing,XING Xin,ZHANG Jing-de,LI Jun-hui,WANG Xiao-yun (Department of Plastic Surgery,Changhai Hospital Affiliated the Second Military Medical University,Shanghai 200433,China) Abstract:ObjectiveTo evaluate the application of subcutaneous pedicle nasolabial flap in upper lip defectss repair.MethodsFrom June 2006 to April 2010,the subcutaneous pedicle nasolabial flap was designed to repair upper lip defect in 31 patients.The flap were designed adjacent to the defects and the incision line corresponded to the nasolabial line.We undermined the flap downwards and outwards to form a subcutaneous pedicle nasolabial flap,then Slided or rotated the flap to cover the upper lip defects.Results31 cases with upper lip defectss were repaired with subcutaneous pedicle nasolabial flap. All the flaps survived and cosmetic results were satisfactorywithout dog-ear or visible scar． ConclusionThis method is easy to perform with a high successful rate,and may be one of the most ideal methods in upper lip defectss repair. Key words：nasolabial flap; subcutaneous tissue pedicle flap；upper lip defectss; repair 上唇部位于面部的暴露部位，轻微缺损就会严重影响面部形象，而不合适的手术修复方法又会造成局部外观的改变，给患者造成严重的心理压力。采用鼻唇沟皮下组织蒂皮瓣修复是一种目前来说比较好的修复方法[1]。2006年6月～2010年4月间，我科应用此方法修复了上唇缺损31例，术后皮瓣全部成活，局部组织器官无明显变形，远期观察瘢痕不明显，手术效果较为满意。 1资料和方法 1.1 临床资料：本组31例，男17例，女14例，年龄31～62岁，平均年龄41岁。病因分别为：色素痣14例，肿瘤12例， 瘢痕5例。切除肿物后遗留的缺损均较大，无法直接拉拢缝合。缺损大小由2.0cm×2.0cm～4.0cm×4.5cm。 1.2 手术方法 1.2.1 肿物切除及皮瓣设计：在局麻或全麻下，距肿物一定距离切除肿物，切口距病变边缘的距离：色素痣为 1～2mm；基底细胞癌和鳞状细胞癌为 5～8mm，瘢痕则贴近边缘。依据面部分区及器官的亚单位分区原则设计鼻唇沟皮瓣，面积约于缺损相当，长轴与患侧鼻