改良岛状皮瓣修复面部缺损的临床观察

Clinical Observation of Reconstruct Facial Defect by Island Skin Flap with Lateral Pedicled Modification

目的探索改良岛状皮瓣术式在修复面部缺损治疗中的应用效果。方法回顾性分析2017年-2019年于我院接受头面部改良和传统的岛状皮瓣修复术的患者。分别对术后7 d和3个月术区照片进行评价,并对患者进行满意度调查,以评估改良后岛状皮瓣对头面部美观度的影响。结果研究共纳入78例患者,实验组(改良皮瓣)49例,对照组(传统皮瓣)29例,两组手术伤口均一期甲级愈合。不良反应:实验组皮瓣远端瘀滞性缺血1例,对照组伤口延迟出血1例。观察者术后7 d评价及患者满意度调查实验组显著优于对照组(P=0.0345),观察者术后3个月评价两组之间无显著差异(P=0.215)。结论改良的岛状皮瓣可有效解除组织蒂的回缩力,避免牵拉畸形的发生,有更理想的术后美观度和更高的患者满意度,值得在头面部缺损修复中应用。

Objective To explore the application of modified island flap in the treatment of facial defects.Methods Retrospective clinical study was performed on patients who underwent island flap reconstructive operation in our hospital from 2017 to 2019.The photos of the operative area were evaluated at both 7 days and 3 months after surgery,and the patients'satisfaction investigation were evaluated the aesthetic result of the modified island flap.Results Totally 78 patients were enrolled in the study,including 49 patients in the study group(modified flap)and 29 patients in the control group(traditional flap).Ischemia of the distal flap was observed in one case of the study group,while one case had delayed wound bleeding in the control group.The evaluation by both observer and patients of study group was significantly better than the control group at 7-day post-operation(P=0.0345),and there was no significant difference between the two groups at 3-month(P=0.215).Conclusion The modified island flap can effectively relieve the retraction force of the pedicle soft tissue,avoid the occurrence of pulling malformation,and has better aesthetics result and higher patient satisfaction.It is worthy to applicate in repairing face defects.