额部扩张皮瓣全鼻再造术血运障碍的预防

Prevention of disorder of blood supplying after nasal reconstruction with the expanded forehead flap

目的探讨额部扩张皮瓣全鼻再造术后血运障碍的预防措施。方法2000年以来对18例患者应用以一侧滑车上动静脉为蒂的额部扩张皮瓣加自体肋软骨移植行全鼻再造。结果1例皮瓣远端坏死,其余皮瓣完全存活。结论在应用以一侧滑车上动静脉为蒂的额部扩张皮瓣行全鼻再造时,一、二期手术中避免血管蒂部损伤、受压是预防皮瓣出现血运障碍的关键。

Objective To investigate the prevention of disorder of blood supplying after nasal reconstruction with the expanded forehead flap. Methods The noses of 18 patients were reconstructed with the expanded triangle-shaped forehead flap with unilateral supratrochlear artery and vein, and autologus costal cartilage transplanted simultaneously from 2000. Results The flaps totally survived except one case with distal end necrosis. Conclusion To prevent the disorder of blood supplying after nasal reconstruction with the expanded forehead flap during operation in stage Ⅰ and Ⅱ, the key point was to avoid the damage and oppression of the pedicle with supratroehlear artery and vein.