颞部及耳前SMAS蒂皮瓣在眼周皮肤缺损修复中的应用

Application of the flap by smas pedicle for repair of soft tissue defects around the eyes

目的:探讨颞部及耳前表浅肌肉筋膜(SMAS)蒂皮瓣在眼周皮肤软组织缺损修复中的应用。方法:根据眼周缺损皮肤形状及面积大小沿同侧颞部及耳前设计以SMAS为蒂的皮瓣,用于眼周皮肤软组织缺损的修复,最大皮瓣8.5cm×4.3cm。结果:8例眼周皮肤缺损病人应用同侧SMAS蒂皮瓣修复创面,术后皮瓣全部成活,经6个月～2年随访,发现皮瓣与周围皮肤组织在色泽、质地、轮廓等方面较匹配,切口瘢痕平软而且较隐蔽。面部的轮廓及视觉效果良好,其形态及美学效果均满意。结论:颞部、耳前SMAS蒂皮瓣在设计上遵循了面部分区原则,而且血供丰富,手术简单易行,是较大面积眼周皮肤缺损创面修复的理想选择。

Objective To explore the application of the flap in front of the ear supported by superficial muscle aponeurosis system （SMAS）pedicle for the repair of soft tissue defects around the eye. Methods The flap in front of the ear supported by SMAS pedicle were designed by the shape and area of the defects and used for the repair of defects around the eye. The biggest flap was 8.5cm×4.3cm. Results The transplanted flaps survived well without any obvious complications. All patients repaired with the flaps supported by SMAS pedicle were followed for 6～24 months.The color and texture of the transplanted flap were matched with the surrounding tissue,incision lines were obscured. Facial contour and appearance were good,and cosmetic results were satisfactory. Conclusions Based on the principles of facial aesthetic subregions, application of the flap in front of ear supported by SMAS pedicle is easily completed and is an ideal choice in repairing the large scale defects around the eye.