局部皮瓣在鼻面部皮肤恶性肿瘤切除术后缺损修复中的应用

Application of Local Skin Flaps in Repair of Defects after Resection of Nasal and Facial Skin Malignant Tumors

目的:探讨局部皮瓣在鼻面部皮肤恶性肿瘤切除后缺损修复中的应用效果。方法:选择鼻部恶性肿瘤切除术后致鼻部皮肤组织缺损的85例患者,根据缺损位置、范围、类型和患者要求,设计局部皮瓣修复鼻部皮肤缺损创面,术后定期随访1年。结果:85例患者中,81例缺损区应用局部皮瓣修复后达到一期愈合(95.29%),3例患者皮瓣尖端发生缺血性坏死(3.53%),1例患者切口轻度感染(1.18%),经换药处理后创面愈合,供区均未形成继发性缺损。修复后创面皮肤色泽、质地、美观、功能评分均明显高于修复前,差异有统计学意义(P<0.05)。85例患者满意度为98.82%(84/85),术后随访1年,无肿瘤复发情况。结论:对于鼻面部皮肤恶性肿瘤切除后患者,根据缺损创面的大小、位置、形态及周围皮肤情况设计局部皮瓣进行修复,能够获得满意功能和美容效果。

Objective To investigate the effect of local flap in the repair of defects after resection of nasal and facial skin malignant tumors. Methods A total of 85 patients with nasal skin tissue defects after nasal malignant tumor resection were selected. According to the location, range and type of defect and patient requirements, local skin flaps were designed to repair nasal skin wounds. The patients were followed up for one year after surgery. Results Among the 85 patients, 81 patients achieved primary healing after local flap repair(95.29%), 3 patients had ischemic necrosis at the tip of the flap(3.53%), and one patient had mild incision infection(1.18%). After dressing change, the wound healed, and no secondary defect was formed in the donor area. The scores of skin color, texture, beauty and function after repair were significantly higher than those before repair, and the differences were statistically significant(P<0.05). The satisfaction of 85 patients was 98.82%(84/85). There was no tumor recurrence after follow-up for one year. Conclusion For patients undergoing nasal and facial skin malignant tumor resection, local flaps designed according to the size, location, shape and surrounding skin conditions for repairing defects can achieve satisfactory functions and cosmetic outcomes.