眶部眼轮匝肌蒂筋膜瓣修复眼睑皮肤缺损

Eyelid skin defect recontruction with fascial flap pedicled with orbicularis oculi muscle in orbital zone

目的探讨眶部眼轮匝肌蒂筋膜瓣修复眼睑皮肤缺损的可行性及临床效果。方法 2016年5月至2017年12月,收治眼睑肿瘤或烧伤后瘢痕患者14例,病变组织切除后遗留创面2.0 cm×1.0 cm～3.0 cm×2.0 cm,根据创面位置及形态,设计眶部眼轮匝肌蒂筋膜瓣推进修复眼睑皮肤缺损,供区直接拉拢缝合。结果术后皮瓣全部成活,均未发生血运障碍、青紫、肿胀等。随访3个月～2年,平均15个月,肿物未复发,瘢痕不明显,眼睑形态及睁眼、闭眼功能良好,患者对手术效果满意。结论眶部眼轮匝肌蒂筋膜瓣可以较好地修复眼睑皮肤缺损,术后眼睑外观及功能恢复良好,对供区影响较小。

Objective To evaluate the feasibility and clinical effect of fascial flap pedicled with orbicularis oculi for reconstruction of the eyelid skin defect in orbital zone. Methods Between May 2016 and December 2017,14 cases with the eyelid tumor or additional scar resulted from burn injury were included in this study.The lesions size ranged from 2.0 cm×1.0 cm to 3.0 cm ×2.0 cm in diameter.Fascial flap pedicled with orbicularis oculi in orbital zone was designed to repair the defect according to the location and shape of the wound,and the donor site was sutured directly. Restults All of the 14 flaps completely survived,no complications such as vein congestion,cyanosis and swelling was found.All of the patients were followed up for 3 months to 2 years (average 15 months),with no tumor recurrence and inconspicuous scar.The shape of eyelid and the function of eyes'opening and closing were good,and the patients were satisfied with the surgical results. Conclusion Fascial flap pedicled with orbicularis oculi in orbital zone,which could achieve good cosmetic and functional effect of eyelid,with little influence to the donor site,is an optimal choice to reconstruct the defect of eyelid skin.