扩张颞浅血管蒂头部皮瓣移植联合激光脱毛修复面部皮肤缺损

Scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects

目的探讨扩张颞浅血管蒂头部皮瓣移植联合激光脱毛修复面部皮肤缺损的临床效果。方法2010年1月至2011年12月，对6例面部大面积瘢痕患者，应用扩张颞浅血管蒂头部皮瓣移植联合激光脱毛治疗。治疗过程分三期进行。一期：根据面部瘢痕的大小和形状在同侧头部放置皮肤扩张器，术后定期注水扩张。二期：待扩张头皮组织量达到要求后，取出扩张器，形成颞浅血管蒂的头部皮瓣，移植修复面部皮肤缺损。三期：二期术后2周，开始对移植皮瓣进行激光脱毛，一般4—6次治疗后皮瓣毛发消脱干净。结果6例7块皮瓣完全覆盖面部皮肤缺损，血供良好，全部存活，供区皮肤直接拉拢缝合；激光脱毛效果肯定。经术后6个月至1年随访，皮瓣与周围皮肤组织在色泽、质地、厚度等方面较匹配，面部轮廓、形态及美学效果均满意。结论扩张颞浅血管蒂头部皮瓣移植联合激光脱毛是修复面部大面积皮肤缺损的较好方法。

Objective To investigate the therapeutic effect of scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects. Methods From Jan. 2010 to Dec. 2011, 6 cases with large facial skin defects were treated with scalp flaps pedicled with superficial temporal vessel and hair removal. At the first stage, the skin expanders were implanted subcutaneously at the homolateral side according to the defect size. After the expansion was finished, the expanded flaps pedicled with superficial temporal vessel were used to reconstruct the facial skin defects at the second stage. 2 weeks after operation, hair removal was performed to remove the hair on flaps. 4-6 treatments were needed. Results Seven flaps in 6 cases were survived completely. The wounds at donor sites were closed directly. The effect of hair removal was reliable. The patients were followed up for 6 months to 1 year. The flap color, texture and thickness had a good match with surrounding skin tissue. Conclusions It is a good option to reconstruct facial skin defects with scalp flaps pedicled with superficial temporal vessel and hair removal.