应用颞浅及眶上滑车上血管为双蒂的额部扩张皮瓣修复面部缺损

Reconstruction of facial defects with frontal expanded flaps bipedicled by superficial temple vessels and supraorbital/supratrochlear neurovascular bundles

【摘要】目的探讨以颞浅及眶上滑车上血管为双蒂的额部扩张皮瓣转移修复面部大面积缺损的方法和疗效。方法2006年6月至2013年3月，选择额部皮肤正常、病损部位以单侧面部为主，但跨越面部中线、涉及颞部的18例患者，一期植入适量扩张器，二期取出扩张器，利用面部扩张皮瓣和以颞浅及眶上滑车上血管为双蒂的额部扩张皮瓣修复病损，三期断蒂并利用蒂部皮肤修复残留病损。结果18例患者均未出现皮瓣缺血坏死，皮瓣色泽、质地均接近面部正常皮肤，外形良好，术后随访1年，患者及家属均满意。结论应用颞浅及眶上滑车上血管为双蒂的额部扩张皮瓣可以较好地修复大面积面部缺损，转移皮瓣血供得到保障，并可避免皮瓣远端缺血坏死。

Objective To investigate the therapeutic effect of reconstruction of facial defects with frontal expanded flaps bipedicled by superficial temple vessels and supraorbital/supratrochlear neurovascular bundles. Methods From June 2006 to Mar. 2013, the patients with mostly unilateral facial defects which affected temple area and crossed the facial midline, were treated with frontal expanded flaps. The expanders were implanted at first stage and the expanded frontal flaps were transferred at second stage. At third stage, pedicle division was performed and the pedicle skin tissue was used to repair the residue defect. Result All the 18 flaps survived completely with satisfactory color and texture. Good results were achieved during the follow-up period of one year. Conclusion The bipedicled frontal expanded flap has a reliable blood supply which is very suitable for large facial defect.