超大耳廓复合组织瓣游离移植修复鼻下部全层缺损

Repairing lower nasal defects with superlarge auricle combination tissues

目的:探讨超大耳廓复合组织瓣游离移植修复大面积鼻下部全层缺损的应用效果。方法:根据患者鼻下部缺损的范围大小,采用超过常规大小的耳廓复合组织瓣游离移植进行修复。术中彻底松解瘢痕组织,扩大接触面,制作血运良好的受区,将耳廓复合组织瓣楔形植入,适当加压包扎固定,术后2周拆线。结果:10例患者修复缺损面积1.5cm×1.5cm～2.2cm×2.0cm,均完全存活。随访1～12个月,鼻下部大小及外观形态均满意,其中2例术后表皮部分剥脱。结论:通过制作血运良好的受区、精细微创的操作和术后适当压力包扎固定及改善微循环、促进移植组织瓣的血供营养等措施,对于鼻下部全层缺损面积大于1.5cm×1.5cm的患者,超过常规大小的耳廓复合组织瓣游离移植修复是较理想的术式选择。

Objective：To discuss the repairing of lower nasal defects with superlarge auricle combination tissues. Methods：According to the size of the lower nasal defects, superlarge auricle combination tissues were employed for the repairing. After excising the scar, expanding the interlace and making favorable receipt area,the superlarge auricle combination tissues were inserted into the defects with pressm＇e dressing compactly. The sutures were removed after two weeks. Results：The operation was successful in all the 10 patients. The maximum defect area was 2.2 cm ×2.0 cm and minimum was 1.5 cm ×1.5 cm. The follow-up visit from 1 to 12 months showed that all the patients were satisfied with the size, figure and color of the repaired nasal defects, excepting for 2 patients whose transplantation auricle combination tissues had part of epidermal tripping. Conclusions： Lower nasal defects with areas larger than 1.5 cm × 1.5 cm can be repaired by superlarge auricle combination tissues by making favorable receipt area, elaborate operation, proper postoperative pressure dressing,improving microcireulation and promoting uourishment of the transplant tissue flap.