颈部皮肤扩张在面颊皮肤缺损中的应用

Neck skin expansion in repairing defect of cheek

目的 总结 13年来借助于皮肤软组织扩张器行颈侧部皮肤扩张 ,修复面颊部组织缺损 113例经验 ,寻找不同的情况不同修复的最佳方法。方法 采用 3种不同的手术方法 :①皮肤扩张单纯皮瓣推移法 ;②易位皮瓣转移法 ;③颈侧皮肤接力扩张法。结果 本组 113例 ,易位皮瓣 2 6例 ,推移皮瓣 5 2例 ,接力扩张修复 35例 ,所形成的皮瓣无 1例坏死。其中并发血肿 2例 ,血清肿 5例 ,扩张器外露 6例 ,扩张器成角 10例 ;术后行Ⅱ期切口瘢痕整复 19例。结论 对于面颊部瘢痕在颈侧皮肤正常的情况下应首选扩张术。单纯皮瓣推移法适用于面颊下部而不影响口唇及颏部的瘢痕修复 ;颈侧易位皮瓣的修复适用于面颊下部、耳屏前部、口角及唇颏部的瘢痕 ;颈侧皮肤接力扩张修复适用于全面颊的瘢痕 。

Objective To summarize the lateral neck skin expansion repair in tissue defect of cheek in 113 cases during past 13 years, look for a best method for different condition and different repairs. Methods 3 types of operation methods for skin defect of cheek were used. ①The lateral neck skin advanced flap; ②The lateral neck skin transposition flap;③The lateral neck skin relay expansion method; Results In 113 cases, there were 52 cases of advanced flap transposition flap in 26 cases, the relay expansion flap in 35 cases, no one flap necrosis occured. the complications were: hematoma 2 cases, seroma 5cases, expander expose 6 cases, expander form angle 10 cases. In 19 cases second stage scar excision were performed. Conclusion The expansion is a best choice for defect of cheek when lateral neck skin is normal. The advanced flap is used for lower area of cheek without influence on lip and chin scar repair; the transposion flap is used for inferior area of cheek, area front to ear, angle of mouth, lip and chin; the relay expansion flap is not only used for defect of whole cheek scar, but also may prevent extropion of lower eyelid