颌面部组织缺损邻位皮瓣修复观察

Clinical Study of Vicinal Skin Flap Repairing Maxillofacial Tissue Defect

目的探讨颌面部病变切除后遗留的创面或因外伤造成的组织皮肤缺损(不能或不宜直接缝合者)的修复方法。方法回顾性分析1996～2002年诊治的37例颌面部组织缺损的临床资料,在颌面部组织缺损设计原则上尽量利用邻位组织瓣为主,必要时也选用远处组织瓣或舌瓣、腭瓣等修复之。其中应用鼻唇沟瓣18例,鼻唇沟瓣旋转灵活,主要用于上、下唇组织缺损修复;邻位颌面部旋转皮瓣16例,用于修复颌面部小型组织缺损;邻位颈部旋转皮瓣3例,整复较大的颌面组织缺损,供瓣区创面可行全厚皮片游离移植。结果37例皮瓣转移全部成活,术后随访2年,面部形态及功能满意。结论颌面部组织缺损修复宁近勿远,就近取材,邻位皮瓣移位方便,手术操作简单,是最为理想的颌面部组织缺损创面修复方法之一。

Objective To explore the repairing methods about maxillofacial tissue defect and skin defect caused by maxillofacial disease and injury. Methods 37 clincal data on maxillofacial tissue defect from 1996 to 2002 were analyzed. According to the designing principles of maxillofacial tissue defect,vicinal tissue flaps are of the widest possible use.When necessary,distant tissue flaps,tongue flaps or palate flaps are chosen for the repair.Nasolabial flap was used in the 18 patients for the tissue defect of upper and lower lips.Vicinal maxillofacial tissue rotation skin flap was used in 16 patients for the tissue defect of small style of maxillofacial.Vicinal cervical rotation skin flap was used in 3 patients for the tissue defect of maxillofacial. Results All 37 skin flaps survived.The recovery of functions and shapes are satisfactory 2 years after the operations. Conclusion It is better to choose vicinal materials instead of distant materials for repairing maxillofacial tissue defect because it is convenient and simple.The method is best one.