眼轮匝肌肌皮瓣修复眼睑分裂痣

The treatment of divided nevus of eyelid with the orbicularis oculi musculocutaneous flap

目的 采用眼轮匝肌肌皮瓣一期修复眼睑分裂痣切除后的皮肤缺损。方法 自拟切除眼睑病变皮肤的内侧开始行Hughes睑劈开术至外眦角。切除上、下睑病变区皮肤 ,在创面的外侧设计宽度与创面相等、长度约 3倍于创面的眼轮匝肌肌皮瓣 ,皮瓣蒂部位于内侧端 ,在眼轮匝肌深面掀起皮瓣 ,将皮瓣向内推进 ,并在外眦角处将皮瓣作部分全层切开 ,以适应外眦的形态 ,一期修复上、下睑皮肤缺损。供瓣区分层直接缝合。结果 共治疗 6例 ,皮瓣最大面积 4cm× 3cm ,均一期愈合 ,形态满意。结论 眼轮匝肌肌皮瓣可以一期修复中度大小的眼睑分裂痣 ,方法简单 。

Objective To improve the result of treatment for divided nevus of eyelid, the orbicularis oculi musculocutaneous flap is used to reconstruct the defect in one stage. Methods\ Under local or general anesthesia, Hughes method was used to divide the palpebral edges to the lateral canthus. The divided nevus on the upper and lower eyelid was excised. An orbicularis oculi musculocutaneous flap, with the same width as the defect and three times length of the defect, was designed and resected under the orbicularis oculi muscle at the lateral side of the defect. The muscular pedicle was on the medial side of the flap. At the lateral canthus, the flap was incised partially to form the contour of lateral canthus in one stage. The donor site was closed directly. Results\ 6 patients were treated with this method. The flap healed primarily with satisfactory cosmetic appearance. The largest flap is 4cm×3cm. Conclusions\ This method can be used to repair the defect of moderate sized divided nevus of eyelid in one stage. The operation technique is simple and the results are satisfactory.