对偶三角皮瓣重建男性乳头

Reconstruction of male nipple with dual triangular skin flap

目的探讨对偶三角皮瓣重建男性乳头的临床效果。方法2011年10月至2019年3月江西省人民医院收治4例男性乳头平坦或缺失患者,年龄29~45岁,平均37.2岁。其中先天性双侧乳头平坦1例,药物腐蚀致双侧乳头缺失1例,外源性损伤、双侧乳头重建失败后乳头平坦2例。根据乳头和乳晕区皮肤血运情况及弹性,设计对偶三角皮瓣行双侧乳头重建。术后对皮瓣成活情况进行观察,并对乳头感觉和形态进行随访。结果4例患者8个乳头中7个乳头完全存活,两侧基本对称,无皮瓣感染及坏死;1个乳头出现局部皮瓣坏死,直径稍增宽,高度降低。术后12个月随访时重建乳头软,感觉良好,乳头高度3~4 mm,直径约5 mm,7个乳头形态良好,1个乳头形态稍差。结论根据乳晕区皮肤设计对偶三角皮瓣重建男性乳头,术后两侧乳头对称,外形满意,并发症少,患者满意。

Objective To explore the clinical effect of dual triangular skin flaps for male nipple reconstruction.Methods From October 2011 to March 2019,we admitted 4 male patients with flat or missing nipples,aged 29 to 45 years old,with an average of 37 years old in Jiangxi Provincial People’s Hospital.Among them,there was 1 case of congenital bilateral flat nipples,1 case of bilateral nipple loss caused by drug corrosion,and 2 cases of exogenous injury with failure history of bilateral nipple reconstruction.According to the blood supply and elasticity of the skin of the nipple and areola,dual triangular flaps were designed for bilateral nipple reconstruction.The survival of the skin flap was observed and the sensation and shape of the nipple were followed up.Results Among the 4 patients with 8 nipples,7 nipples were fully survived symmetrically with no skin flap infection and necrosis.One nipple had local flap necrosis,resulted in wide and flat nipple appearance.During the 12-month follow-up,the reconstructed nipples were soft and felt good.The height of the nipple was 3-4 mm,the diameter was about 5 mm,7 nipples were in good shape,1 nipple was slightly small.Conclusions Dual triangular skin flaps is a good choice for male nipple reconstruction with satisfactory symmetrical appearance and less complication.