局部皮瓣修复面部皮肤肿瘤术后缺损的疗效

Efficacy of local flap for repair of post-tumor surgery on the face

目的 探讨局部皮瓣在面部皮肤肿瘤术后缺损修复的疗效。方法 选取遵义市第一人民医院2018年1月至2023年3月手术治疗的面部皮肤肿瘤患者,共41例,包括基底细胞癌19例,鳞状细胞癌(含角化棘皮瘤)16例,色素痣5例,表皮囊肿并感染1例。根据术后面部缺损不同部位及大小,使用易位皮瓣、推进皮瓣、旋转皮瓣等类型的局部皮瓣一期修复创面,恶性肿瘤者经病理回示边缘及基底无肿瘤细胞后再行局部皮瓣修复。所有缺损修复时切缘不能有太大张力,均行皮下缝合及皮肤缝合,术后5~7 d拆线。结果 拆线时41例患者局部皮瓣均存活,面部轮廓基本正常,面部器官游离缘无扭曲;随访6~12个月,术区功能恢复良好,皮瓣色泽与周围组织较好匹配,平整度可、质地柔软,局部无牵拉变形、无明显瘢痕增生。结论 局部皮瓣修复面部缺损有较好功能恢复及美容修复效果。

Objective To investigate the efficacy of local flap for repair of post-tumor surgery on the face.Methods Forty-one patients with facial skin tumors,including basal cell carcinoma(19 cases),squamous cell carcinoma(16 cases),pigmented nevus(5 cases),and 1 case of epidermal cyst with infection,who were surgically treated at the First People′s Hospital of Zunyi City from January 2018 to March 2023,were included in this study.According to the site and the size of postoperative facial defects,various types of local flaps were used for one-stage repair of the defects,including transposition flaps,advancement flaps,and rotational flaps.Those with malignant tumors were pathologically proven to be free of tumor cells at the margins and base first,and then local flaps were used for repair.All the defects were repaired without too much tension on the incision margins when subcutaneous sutures and skin sutures were performed.The sutures were removed 5 to 7 days after surgery.Results At the time of suture removal,all local flaps in 41 patients survived with normal facial contour and with no distortion of the free edges.At the follow-up of 6 to 12 months,the function,skin color and texture appeared normal without local pulling deformation or hyperplastic scar in the operated area.Conclusion Local flap repair of facial defects displays good functional and cosmetic outcomes.