推进皮瓣修复下颌部瘢痕的临床应用

Clinical application of advancement flaps in repairing mandibular scars

目的探讨颈部推进皮瓣修复下颌部瘢痕的临床应用效果。方法回顾性收集2018年1月-2020年7月四川大学华西医院整形外科/烧伤科收治的下颌部瘢痕患者的临床资料。分析患者术前和术后2周X线侧位片,比较手术前后颏颈角及颈颏角之间的差异。结果共纳入21例患者,其中男性7例,女性14例。入院时所有患者的下颌部瘢痕面积为(3~7)cm×(3~6)cm,均采用颈部推进皮瓣一期修复。所有患者术后皮瓣存活良好,切口一期愈合,颏颈角及颈颏角明显。患者术前颏颈角为(110.24±9.47)°,术后2周时颏颈角为(98.39±4.95)°,差异有统计学意义(P<0.05);术前颈颏角为(134.15±6.00)°,术后2周时颈颏角为(126.44±3.60)°,差异有统计学意义(P<0.05)。结论颈部推进皮瓣是处理单纯下颌部瘢痕的有效手术方式,此术式简易且能改善颌颈部外观。

Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars.Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020.The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery,and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared.Results A total of 21 patients were included,including 7 males and 14 females.At admission,all patients had a mandibular scar area of(3-7)cm×(3-6)cm,and underwent primary repair with cervical advancement flaps.All patients had good postoperative skin flaps survival,primary wound healing,and obvious mento-cervical angle and cervico-mental angle.The preoperative mento-cervical angle was(110.24±9.47)°,and at 2 weeks post surgery,the mento-cervical angle was(98.39±4.95)°,with a statistically significant difference(P<0.05).The preoperative cervico-mental angle was(134.15±6.00)°,and at 2 weeks post surgery,the cervico-mental angle was(126.44±3.60)°,with a statistically significant difference(P<0.05).Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar,which is simple and can improve the appearance of the jaw and neck.