适形前臂桡侧皮瓣修复面颊部软组织缺损的效果评价

Evaluation of the application of conformal radial forearm flap in repair of irregular facial soft tissue defects

目的:评价适形前臂桡侧皮瓣游离移植修复面颊部不规则皮肤软组织缺损的临床效果。方法:选择2020年1月—2021年12月徐州市中心医院收治的面颊部外伤或肿瘤导致的不规则皮肤软组织缺损患者9例,设计个性化、适形前臂桡侧皮瓣游离修复缺损区,观察患者术后短期内皮瓣修复效果及患者满意度,应用抑郁自评量表(self-rating depression scale,SDS)及焦虑自评量表(self-rating anxiety scale,SAS)评估患者手术前后心理状态。采用SPSS 20.0软件包对数据进行统计学分析。结果:术后皮瓣均顺利存活,术后2周患者SDS评分、SAS评分显著低于术前(P<0.05)。8例患者的皮瓣与周围皮肤组织厚度、色泽无明显差异,无牵拉及不对称,外观与功能修复效果满意,满意度为88.89%。结论:利用适形前臂桡侧皮瓣游离修复面颊部不规则软组织缺损效果良好,术后短期内患者焦虑和抑郁评分改善明显,满意度高,值得临床应用。

PURPOSE:To evaluate the effect of free transplantation of conformal radial forearm flap in the repair of irregular skin and soft tissue defects in the cheek.METHODS:Nine patients with irregular skin and soft tissue defects caused by facial trauma or tumor treated in Xuzhou Central Hospital from January 2020 to December 2021 were selected.Personalized matching free forearm flap were designed,the short-term effect of skin flap repair and patient satisfaction were observed.Self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were used to evaluate the psychological state of patients before and after surgery.SPSS 20.0 software package was used for data analysis.RESULTS:All the flaps survived smoothly after operation.The SDS score and SAS score of patients 2 weeks after operation were lower than those before operation,and the difference was statistically significant(P<0.05).There was no significant difference in thickness and color between the flap and the surrounding skin,no traction and asymmetry,and the effect of appearance and functional repair was satisfactory.The satisfaction rate was 88.89%.CONCLUSIONS:The free radial forearm flap with conformal shape has a good effect in repairing irregular soft tissue defects in the cheek.The scores of anxiety and depression improved significantly in the short term af-ter operation,and the patients have high postoperative satisfaction;therefore,it is worthy of clinical application.