皮下组织蒂皮瓣修复面部缺损美容性重建的临床效果

Clinical efficacy of subcutaneous pedicle flap in functional and cosmetic reconstruction on facial defects

目的探讨皮下组织蒂皮瓣修复面部皮肤软组织缺损的临床效果。方法自2005年7月至2015年7月，对257例患者采用不同类型皮下组织蒂皮瓣修复面部皮肤缺损创面，包括以皮下脂肪组织为蒂，以眼轮匝肌为蒂，以鼻部表浅肌腱膜组织为蒂等，通过推进、旋转或皮下隧道等不同方式修复创面。结果255例Ⅰ期愈合，2例皮瓣远端部分坏死，经换药后愈合，177例随访3个月至5年，修复组织与周围皮肤组织在色泽、质地、轮廓等方面相似，瘢痕不明显，面部外观及重要器官功能获得满意的修复效果。结论在遵循分区修复的基础上，通过运用单个或多个以皮下组织为蒂的皮瓣对面部皮肤软组织缺损创面进行美容性重建，能够达到满意的临床效果。

Objective To introduce the experience and comprehension of application ot subcutaneous pedicle skin flap in repair of facial defects. Methods From July 2005 to July 2015, the different kinds of subcutaneous pedicle flaps were used to repair skin defect of the facial lesions in 257 patients, including the flaps with subcutaneous adipose tissue pedicle, with the orbicularis oculi muscle pedicle and with superficial musculoaponeurotic system pedicle, through advancement, rotation or subcutaneous tunnel transfer ways. Results After operation, 255 cases survived with primary healing except for two patients with partial flap necrosis; 177 eases were followed up from 3 to 60 months, and all were satisfaied with natural repaired tissue that matched well with surrounding tissue at color, texture, contour, and so on. Conclusions Following the principles of the zonation repair in face, it can obtain satisfactory facial contour and cosmetic effect for patients with facial defects hy using one or more subcutaneous pedicle flaps.