预扩张眼轮匝肌皮瓣在眶下区皮肤软组织缺损修复中的应用

Application of Pre-expanded Orbicularis Oculi Myocutaneous Flap in the Repair of Skin and Soft Tissue Defects in the Infraorbital Region

目的:探讨一种眶下区皮肤软组织缺损的美学修复方法。方法:对12例眶下区皮肤软组织缺损的患者,进行眼轮匝肌皮瓣区域的皮肤预扩张,修复皮肤软组织缺损。手术分两期进行,一期手术于颞颧部眼轮匝肌皮瓣范围内预先埋置相应大小的皮肤软组织扩张器;注水扩张2~4个月,待皮肤扩张达所需面积后,二期手术切除病变组织,以同侧眼轮匝肌为蒂,携带颧颞部扩张皮瓣转移修复缺损创面。结果:所有患者手术顺利,无皮瓣坏死,皮瓣全部成活,皮瓣颜色、质地良好,外观接近正常,患者及医生满意度高。结论:预扩张眼轮匝肌皮瓣用于眶下区皮肤软组织缺损修复大小可超过常规眼轮匝肌皮瓣所能覆盖的面积,且眼轮匝肌皮瓣区域有可供扩张皮瓣,其皮瓣血运可靠,美学效果良好,是一种值得推广的手术治疗方法。

Objective To explore a aesthetic repair method for skin and soft tissue defects in the infraorbital region.Methods 12 patients with skin and soft tissue defects in the infraorbital region were treated with skin pre-expansion of the orbicularis oculi myocutaneous (OOM) flap to repair the skin and soft tissue defects.The operation was divided into two stages.In the first stage,the corresponding size of skin and soft tissue expander was implanted in the scope of temporal zygomatic OOM flap.After 2-4 months of water injection,the skin was expanded to the required area,the diseased tissue was resected in the second stage.The defect was repaired with the zygomatic temporal expanded flap pedicled with OOM on the same side.Results All the flaps survived with good color,texture and appearance.The satisfaction of patients and doctors was high.Conclusion The pre-expanded OOM flap is used for facial skin and soft tissue defect,which is larger than the area that can be covered by conventional OOM flap,and the region of OOM flap has normal skin tissue for expansion.The flap has reliable blood supply and good aesthetic effect,which is worthy of promotion.