耳屏前穿支岛状瓣在耳郭前外侧面缺损中的修复

Repair of auricle anterolateral aspect defect with pretragal perforator island flap

目的探讨利用耳屏前穿支岛状瓣修复耳郭前外侧面缺损的新方法。方法使用多普勒超声血流探测仪标记耳屏前穿支血管的位置;根据缺损部位的大小、创面远端至耳屏的距离、耳郭皮肤的松弛程度,设计以耳屏前动脉穿支为蒂的皮瓣;切开皮瓣远端,紧贴sMAs筋膜浅面由远端开始向近端分离,形成穿支蒂皮瓣,转移覆盖至创面,供区直接拉拢缝合。结果所有皮瓣存活良好,切口一期愈合。随访6~12个月,未发生皮瓣臃肿、明显瘢痕、面部"猫儿"畸形等并发症,形态功能效果均满意。结论耳屏前穿支岛状瓣修复耳郭前缺损,皮瓣设计简单,血供丰富,操作方便,供区切口隐蔽,效果满意,值得临床推广。

Objective To explore a new method for the repair of auricle anterolateral aspect defect.Methods Prior to surgery,Doppler ultrasound blood flow detector was used to mark the location of the pretragal perforator vessel.Pretragal artery perforator pedicled flaps were designed with the following considerations：defect area,distance from the wound distal to the antilobium,and degree of laxity of the auricle skin.The distal flap was incised,separated from the distal to the proximal,andclose to the superficial layer of the SMAS fascia,and the perforator pedicled flap was formed.The flap was transferred and the defect was covered.The donor site was closed and sutured direcdy.Results All flaps survived well and healed primarily.Follow-up was performed from 6 to 12 months postoperative.No swelling,obvious scars,or facial malformation occurred.All patients felt satisfied with the appearance and functional results.Conclusion The pretragal perforator island flap has the following advantages：simple design,rich blood supply,convenient operation,and hidden donor incision.It is feasible for promotion in clinical application.