O-Z-O皮瓣在面部相邻皮肤缺损修复中的应用

Application of O-Z-O flaps in repair of adjacent facial skin defects

目的探讨应用O-Z-O皮瓣修复面部相邻皮肤缺损的效果。方法回顾性分析2015—2018年于杭州市第三人民医院皮肤科采用O-Z-O皮瓣修复面部相邻皮肤缺损的60例患者。其中,色素痣50例,脂溢性角化病4例,寻常疣3例,基底细胞癌2例,鳞状细胞癌1例。男14例,女46例,年龄18~75岁。根据皮损情况,原位切除皮损,设计最佳切口,离断"皮瓣桥"(即相邻缺损之间的正常组织),根据皮肤张力线以及皱纹线,将两皮瓣桥残端相互交错,间断缝合固定,进行创面修复。结果60例患者应用O-Z-O皮瓣均能完全覆盖皮肤缺损,术后皮损均Ⅰ期愈合,无瘢痕增生。结论O-Z-O皮瓣设计灵活,切口小,可以同时切除相邻皮损并进行减张缝合,临床疗效满意,是修复面部相邻皮肤组织缺损的良好选择。

Objective To evaluate performance of O-Z-O flaps in repair of adjacent facial skin defects.Methods A retrospective analysis was conducted.A total of 60 patients with adjacent facial skin defects receiving O-Z-O flap repair were collected from the Third People′s Hospital of Hangzhou from 2015 to 2018,including 50 with pigmented nevus,4 with seborrheic keratosis,3 with verruca vulgaris,2 with basal cell carcinoma and 1 with squamous cell carcinoma.Among the 60 patients,14 were males and 46 were females,with the age being 18-75 years.According to the condition of skin lesions,in situ resection was performed,and the optimal incision was designed;the"flap bridge",that is,the normal tissue between adjacent defects,was severed;according to the skin tension line and wrinkle line,residual ends of the two flap bridges were interlaced with each other,sutured and fixed interruptedly,and the wounds were repaired.Results The skin defects could be completely covered by O-Z-O flaps in the 60 patients.All the patients received primary healing of incisions without scar hyperplasia after operation.Conclusions The O-Z-O flap has advantages of flexible design and small incisions,and can be used for tension-reducing suture after excision of adjacent skin lesions.It is a good choice for repair of adjacent facial skin defects with satisfactory clinical effect.