应用局部皮瓣修复内眦皮肤缺损15例

Reconstruction of medial canthal skin defects with local flaps： 15 case report

目的 报道局部皮瓣修复皮肤肿瘤切除后的缺损的经验与体会.方法 使用局部皮瓣修复内眦部皮肤缺损15例,创面面积约1 cm×1 cm～1.8 cm × 2.0 cm.根据创面的位置及大小,分别选择眉间皮瓣、旋转皮瓣、推进皮瓣、鼻唇沟皮瓣或联合使用两种局部皮瓣等方法进行修复.结果 15例中12例使用单一皮瓣修复创面,3例使用两个局部皮瓣联合修复创面,共使用18个局部皮瓣,术后皮瓣全部成活,切口Ⅰ期愈合.术后随访11例6个月至1年,皮瓣与周围皮肤组织的色泽、质地相近,切口瘢痕隐蔽,未发生内眦部及附近组织器官明显畸形,形态满意,功能良好.结论 修复内眦部皮肤缺损时,如果能选取合适的局部皮瓣,并注意保持和恢复内眦美容单位的完整性,将取得良好的形态与功能效果.

Objective To reconstruct skin defects with local flaps after resection of tumors. Methods From October 2006 to December 2009, medial canthal defects in 15 patients were repaired with local flaps in the hospital. The size of the defects varied from 1 cm × 1 cm to 1.8 cm × 2.0 cm. According to the size and location of the defects, different local flaps such as glabellar flaps ,rotation flaps, advancement flaps, nasolabial flaps and combination of these local flaps were selected and designed to repair the skin defects. Results Of the 15 patients, 12 received the reconstruction of skin defects with single flap, the other 3 with two flaps; totally,18 local flaps were designed and applied. All the flaps survived with primary healing postoperatively. A followup in 11 patients for 6 to 12 months showed that the color and texture of flaps were similar to those of surrounding tissues and incision line scar was inconspicuous. Medial canthal contours were restored without distortion of surrounding structures. Satisfactory function and aesthetic outcomes were achieved. Conclusions In the repair of inner canthus skin defects, to maintain and restore the ＂cosmetic unit＂ integrity of inner canthus by using suitable local flaps would lead to a satisfying restoration of function and appearance.