上臂内侧带蒂皮瓣在创伤后鼻缺损美容整形中的应用

Cosmetic repair of nasal defects with medial pedicle skin flap of the upper arm

目的探讨上臂内侧皮管（瓣）带蒂移植在创伤后鼻缺损美容整形中的应用。方法 2008年11月~2015年1月,笔者应用上臂内侧带蒂皮管（瓣）修复创伤后鼻缺损11例（男性9例,女性2例;年龄18~43岁）,其中一期皮管（瓣）成形同时转移修复8例,其余3例采用一期上臂形成皮管（瓣）、二期带蒂转移修复鼻缺损、三期皮管断蒂完成鼻再造。结果本组11例患者鼻部转移皮瓣血运良好,鼻腔通气功能良好。随访9例,1~3个月时颜色与周围皮肤相差较大,1年后颜色相近,两侧鼻孔对称,鼻外形良好,基本达到美容修复的目的。结论上臂内侧带蒂皮管（瓣）设计相对不受限制,提供的组织量多,成活率高,在患者不接受面部遗留新瘢痕的情况下,是一种较好的选择方法。

Objective To investigate the methods to repair traumatic defects on nose with medial pedicle skin tube（ flap） of the upper arm. Methods Eleven patients with nasal defects were repaired in our department from Nov. 2008 to Jan. 2015. To repair their defect,all patients were treated with medial pedicle skin tube（ flap） of the upper arm. Among them skin tubes（ flap） were formed,transferred and repaired simultaneously in 8 patients; for the rest 3 patients,skin tubes（ flap） of upper arms were formed in the first stage,nasal defect was transferred and repaired in the second stage,and noses were successfully reconstructed with pedicle division in the third stage. Results All the 11 patients achieved good blood circulation in skin flaps and good ventilation in nasal cavity. The follow-up of 9 patients showed that during the first 3 months after the operation,the color of skin tube（ flap） was obviously different from the surrounding skin,but gradually similar after 1 year. Besides,bilateral nostrils achieved symmetry with good appearance. The cosmetic repair was basically achieved. Conclusion The design for medial pedicle skin tube（ flap） of the upper arm is not restricted comparatively,but it significantly improves the tissue survival rate by supplying sufficient tissue. It might be a better alternative for those patients who prefer not to leave new scars on their faces.