扩张皮瓣在修复眼睑软组织缺损中的临床应用

Application of expanded flaps in repair of eyelid defects

目的:总结应用扩张皮瓣修复眼睑软组织缺损的临床经验。方法:一期手术选用30～100ml容量的扩张器埋置于睑部临近的正常皮肤皮下层,注水扩张3～4月,二期应用不同大小的扩张皮瓣修复眼睑缺损创面,恢复睑缘正常位置。结果:对2005～2009年间的临床病例,应用皮肤软组织扩张术修复眼睑缺损共10例10只患眼,均利用扩张皮肤形成局部皮瓣一次完成修复。术后随访2周～1年,皮瓣全部成活,均获得满意效果,睑缘位置恢复正常,瘢痕不明显,无睑外翻出现。结论:皮肤软组织扩张术可产生过多的额外皮肤,应用扩张皮瓣修复不同程度的睑部软组织缺损是一种较为理想的治疗方法。

Objective To summarize the clinic experiences of application of expanded flaps in repairing soft tissues defects of eyelid. Methods Tissue expanders of 30-100ml in size were implanted beneath the normal skin adjacent to lesions of eyelid. Three to four months after periodically injecting normal saline solution into the expander to slowly expand the overlying skin. Then,the expander was taken out. Different size and rotation of adjacent expanded skin flaps were used to restore eyelid defects. Results From 2005 to 2009, the authors used expanded flaps to repair 10 eyes of 10 patients with different eyelid defects. Follow-up time ranged from 2 weeks to 1 year. ALL of the random expanded flaps survived with reasonable cosmetic results. The postoperative scars were not conspicuous. No complications and recurrence occurred as a result of these treatments. Conclusion Tissue expansion technique can produced ＂extra＂ skin, random expanded skin flap is a better reconstructive option for eyelid defects.