改良V-Y推进皮瓣对面部皮肤肿瘤术后缺损患者的修复效果研究

Study on the repair effect of modified V-Y advancing skin flap on postoperative defects in patients with facial skin tumors

目的探究改良V-Y推进皮瓣对面部皮肤肿瘤术后缺损患者的修复效果。方法前瞻性选取河南宏力医院2020年2月至2023年2月收治的40例面部皮肤肿瘤切除术后皮肤缺损的患者,均接受改良V-Y推进皮瓣修复。结果40例患者皮片和皮瓣全部成活,其中创面为Ⅰ期愈合38例,并发皮瓣边缘部分坏死1例,经局部修剪换药后愈合;切口感染1例,经短期换药后愈合。随访1~12个月,失访1例,于术后1年复发3例,局部肿瘤复发1例,腮腺区淋巴结转移2例,均再次行根治性切除术治疗后行补充放疗,其余患者面部外形、功能均恢复良好36例,伤口美观满意度为94.44%(34/36)。结论改良V-Y推进皮瓣拓宽了V-Y推进皮瓣修复缺损的适应证,降低了术后一期继发性缺损及并发症发生率,皮瓣存活率高,且美观度好。

Objective To explore the repair effect of modified V-Y advancement flap on postoperative defects of facial skin tumors in patients.Methods A prospective study was conducted on 40 patients with skin defects after facial skin tumor resection who were admitted to Henan Hongli Hospital from February 2020 to February 2023.All patients underwent modifified V-Y push flflap repair.Results All 40 patients'skin grafts and flflaps survived,including 38 cases with stage I wound healing and 1 case with necrosis at the edge of the flflap,which healed after local trimming and dressing change.One case of incision infection healed after a short-term dressing change.During the follow-up period of 1-12 months,1 case was lost to follow-up,3 cases recurred within 1 year after surgery,1 case had local tumor recurrence,and 2 cases had lymph node metastasis in the parotid gland area.All patients underwent radical resection again and received supplementary radiotherapy.The facial appearance and function of the remaining patients recovered well in 36 cases,and the satisfaction rate of wound aesthetics was 94.44%(34/36).Conclusions The modifified V-Y advancement flflap broadens the indications for repairing defects,reduces the incidence of secondary defects and complications after surgery,has a high survival rate,and has good aesthetic appeal.