含SMAS的随意型皮瓣在修复睑外翻中的临床应用

Clinical application of random flap with SMAS in treatment of ectropion

目的:探讨应用各种含SMAS随意型皮瓣治疗瘢痕性睑外翻的方法,总结临床上修复瘢痕性睑外翻SMAS瓣的设计和应用。方法:2005年9月～2008年9月,我们采用各种含SMAS的随意型皮瓣共治疗不同程度的瘢痕性睑外翻患者,其中男13例,女11例。年龄6～48岁,平均28岁。结果:术后患者伤口均一期愈合,未见并发症。24例患者随访2周～6月,随访患者皮瓣全部成活,均获得满意效果,睑缘位置正常,无睑外翻的复发。结论:本组患者治疗结果显示应用各种含SMAS的随意型皮瓣治疗瘢痕性睑外翻可获得满意效果,由于SMAS独特的动脉供血系统,皮瓣应用较安全、血供丰富,长宽比例平均可达4:1,最长达6:1,切取灵活,旋转角度大,切口隐蔽,皮肤色泽质地均与睑部皮肤相近,成为修复不同程度瘢痕性睑外翻的理想选择。

Objective To describe the technique of treatment for cicatricial ectropion and investigate the special blood supply of SMAS, to summerize the design and clinic application of the random flaps with SMAS. Methods From September 2005 to September 2008, there were 24 eyes of 24 patients with cicatricial ectropion. We used the contiguous random flaps with SMAS to correct cicatricial ectrpion and defects in the eyelids. The study included thirteen male and eleven female patients with an age range of 6 to 48 years. The mean age was 28 years. Results The followup period ranged from 2 weeks to 6 months. These treatments were successful in all cases. ALL of the random flaps with SMAS survived with reasonable cosmetic results. No complications and recurrence occurred as a result of these treatments. Conclusions The random flap with SMAS has a special sufficient blood supply. The ratio of its length and width can be made to 6：1, average 4：1. These flaps can be transfered flexibly and safely and its dissection is convenient with an occult incision. These flaps minimizes the usual deformity and achieves good results. The skin match is good and donor morbidity is minimal. It is a better reconstructive option for repairing cicatricial ectropion.