颞区皮下蒂皮瓣修复下睑外翻的临床效果观察

Clinical efficacy of subcutaneous pedicle flap from temporal region in treatment of lower eyelid ectrupiun

目的 探讨应用颞区皮下蒂皮瓣修复各种原因所致下睑外翻的手术方法 及临床效果.方法 自2007年以来,对于各种原因所致皮肤全层组织缺损的下睑外翻,以同侧颞部无毛发区为供区,应用外眦动脉分支血管网皮下蒂颞区横行皮瓣修复24例.病因包括：感染瘢痕8例,外伤6例,肿物切除10例,皮瓣面积最大5.5 cm×1.5 cm,最小4.0 cm×1.0 cm.结果 24例术后均未出现皮瓣血运障碍,全部Ⅰ期愈合,随访6个月至3年,皮肤色泽、质地与受区相近,无明显臃肿,外观改善良好,无需Ⅱ期修整;供区瘢痕隐蔽,无明显后遗畸形.结论 外眦动脉分支网皮下蒂颞区皮瓣血供可靠,皮瓣设计灵活,移转后蒂部无臃肿外观,供区瘢痕细小、隐蔽,外形满意.修复全层组织缺损的下睑外翻效果满意,是一种值得推荐手术方法.

Objective To investigate a new method and to observe the clinical effect of repairing the lower eyelid ectropion assisted with the subcutaneous pedicle flap from temporal region. Methods Since 2007, 24 patients with lower eyelid ectropion were treated with the subcutaneous pedicle flap from temporal region which was the donor area without hairs, including 8 cases of scar infection, 6 cases of trauma, and 10 cases of tumor removal. Among the 24 cases of the flap, the maximum area was 5. 5 cm× 1. 5 cm,and the minimum was 4. 0 cm × 1.0 cm. Results All patients were followed up for 6 months to 3 years.All flaps survived completely with excellent texture and appearance. The donor site was hidden and no obvious malformation of the donor site was observed. Conclusions Because the blood supply of flap is reliable and the incision in the donor site is hidden, the subcutaneous pedicle flap from temporal region pedicled with arterial network of the outer canthus is an ideal donor site for repairing the lower eyelid ectropion with full thickness defects.