邻位皮瓣修复颌面部软组织缺损37例临床分析

Application of vicinal skin flap in reconstruction of maxillofacial defects in 37cases

目的:介绍邻位皮瓣在颌面部软组织缺损修复中的应用。方法:2005年1月～2012年6月,对37例由于外伤或手术引起颌面部缺损的患者,采用颌面及颈部邻位带蒂皮瓣进行即刻修复,并进行临床效果观察和总结分析。结果:应用颌面及颈部邻位带蒂皮瓣,对37例颌面部缺损患者,根据不同部位和程度,分别采用局部推进皮瓣,鼻唇沟皮瓣,Abbe瓣等邻位带蒂皮瓣即刻修复,术后皮瓣全部成活。37例患者随访6个月～7年,皮瓣与周围皮肤组织在色泽、质地、轮廓等方面较匹配,切口瘢痕平软,肿瘤患者无复发,4例出现患侧口角轻度偏歪、3例出现轻度张口受限,治疗效果满意。结论:对手术或外伤造成的颌面部软组织缺损,采用局部邻位皮瓣进行即刻修复,因其血供良好、制作方便、灵活,易于掌握,术后易存活,效果满意,值得临床广泛应用,但也需要在术中注意适应证及手术要点。

Objective This study aims to introduce the usefulness of vicinal skin flap in reconstructing maxillofacial defects. Metheods 37 cases with soft tissue defects in the maxillofacial region, caused by various diseases,such as trauma or operation,were instantly repaired with vicinal skin flap from maxillofacial and neck during January 2005 to May 2006.Clinic effect was observed, concluded and analyzed. Results Many kings of local advanced skin fiap,nasolabial groove flap and Abbe fla^l~ were used according to the location and tissue defect degree.All the flaps survived. After 1 month-17 years follow up,the morphology of the reconstructed region was satisfied, and the scar in the donate site was unconspicuous. And no recurrence was found in tumor cases.4 cases had light skew in angle of mouth, 3 cases had little limitation of mouth opening. Conclusion Instantly repair with vicinal skin flap in patients with tissue defects in the maxillofacial region, caused by various diseases,such as trauma or operation !s recommended in clinic. It has many good qualities, such as good blood supply,easily to make,agility and easily to survive. But indication and operation point should be controlled.