不同皮瓣修复面部病灶切除术后软组织缺损的效果探讨

The Effect of Different Kinds of Skin Flaps for the Repair of Soft Tissue Defect after Facial Lesionectomy

目的:探讨不同皮瓣修复面部病灶切除术后软组织缺损的临床应用效果。方法:选取2017年5月-2018年12月笔者科室收治的14例面部皮肤肿物患者作为研究对象,行面部病灶切除术后根据患者面部损伤情况在邻近部位设计不同皮瓣修复。对不同皮瓣修复后的伤口愈合情况及术后6个月随访结果进行回顾分析。结果:14例患者面部缺损大小为1.2cm×1.0cm^4.8cm×2.1cm,采用A-T皮瓣修复1例,带蒂鼻唇沟皮瓣修复6例,带蒂颌下皮瓣修复3例,带筋膜蒂皮瓣修复4例。所有移植皮瓣完全成活,切口均一期愈合。随访6个月发现,皮瓣色泽正常,皮肤血运良好、有触感,面部功能及外观恢复满意。结论:不同皮瓣修复具有不同优势,应根据面部软组织缺损情况采取不同的皮瓣修复术;就近取材或采取多个局部皮瓣进行修复可提高皮瓣成活率,促进愈合,保证面部功能及外观的完整。

Objective To explore the clinical effect of different kinds of skin fl ap for the repair of soft tissue defect after facial lesionectomy.Methods A total of 14 patients with facial skin mass were retrospectively selected from May 2017 to December 2018.After facial lesionectomy,different skin fl aps were designed to repair the adjacent parts according to the patients’facial injuries.The results of wound healing after different fl ap repair and 6 months follow-up were retrospectively analyzed.Results The facial defect range was 1.2cm×1.0cm to 4.8cm×2.1cm.Among the 14 patients,one case was repaired with A-T fl ap,6 cases with pedicled nasolabial groove fl ap,3 cases with pedicled lower jaw fl ap and 4 cases with fascia-pedicled fl ap.All the fl aps survived completely and all the incisions healed in the fi rst stage.The skin fl ap had normal color,good blood supply,tactile sensation,and satisfactory recovery of facial function and appearance.Conclusion Different kinds of fl ap repair have different advantages,so different kinds of fl ap repair should be used according to different defect of facial soft tissue.Nearby materials or take multiple local skin fl ap to repair can enhance the survival rate of skin fl ap,promote the healing,and ensure the integrity of facial function and appearance.