眼睑局部皮瓣在修复睑缘色素痣切除后创面中的应用

Applicaiton of local flap eyelid for reconstruction of the defects of pigmented nevus excision in palpebral margin

目的:介绍睑缘色素痣手术切除后创面修复的方法。方法:根据睑缘色素痣切除后眼睑缺损创面的层次、大小及形状,选用适当的眼睑局部皮瓣修复睑缘缺损,如:"A-T"皮瓣、"风筝"皮瓣、"H"形推进皮瓣。共施行手术38例,其中缺损创面位于上睑缘者23例,下睑缘者15例;睑缘全层缺损9例,睑缘前层皮肤缺损29例;睑缘缺损面积最小者约为0.5cm×0.6cm,最大者约为1.6cm×0.8cm。共利用"A-T"皮瓣16例、"风筝"皮瓣13例、"H"形推进皮瓣9例。结果:本组患者术后皮瓣全部成活,切口均Ⅰ期愈合,其中33例术后获得随访1周～16周,眼睑外观形态良好,眼睑切口无明显瘢痕,睑缘弧线正常自然,双眼睑形态对称,眼睑闭合功能正常。结论:睑缘色素痣因其位置的特殊性,灵活选用眼睑局部皮瓣修复睑缘缺损,能获得满意的眼睑功能和美容性重建效果。

Objective To introduce the methods of reconstruction the defects of pigmented nevus excision in palpebral margin.Methods According to the location,shape and size of the defects,＂A-T＂skin flap、kite skin flap and ＂H＂ advancement flap were chosen to repair the eyelid defects after nevus removal.Since 2000,38 patients were treated,with 16 ＂A-T＂ skin flaps,13 ＂kite＂ skin flaps and 9 ＂H＂ advancement skin flaps.The range of the defect was from 0.5cm×0.6cm to 1.6cm×0.8cm,and 23 cases in upper eyelid,15 cases in lower eyelid,9 full-thickness eyelid defects and 29 anterior lamellar eyelid defects.Results All flaps survived with primary healing.Follow up for 1 to 16 weeks which showed that all cases achieved excellent cosmetic effects and functional results.Conclusions Treating eyelid nevus with local skin flaps is satisfying with excellent color and texture matching,normal eyelid function,and inconspicuous donor deformity.