单蒂推进皮瓣修复颊部内侧手术后皮肤缺损的疗效观察

Effect of Single Advancement Flap on Repairing Medial Cheek Defects after Surgery

目的探讨单蒂推进皮瓣修复颊部内侧恶性肿瘤及癌前病变病灶切除后形成的继发性创面的方法及治疗效果。方法选择12例患者(基底细胞癌6例,光线性角化伴高分化鳞癌1例,鳞状细胞癌1例,光线性角化4例)。不同病种治疗分别切至病灶边缘外4 mm、4 mm、4 mm和3 mm。缺损采用单蒂推进皮瓣修复,皮瓣长度为皮瓣起始部位宽度的2倍左右,皮瓣切取深度为SMAS浅面。结果全部皮瓣存活良好,创面得以Ⅰ期修复。经7个月随访,患者对局部外形满意,未见原病变复发。结论单蒂推进皮瓣可用于修复颊部内侧恶性肿瘤及癌前病变术后形成的一定大小的皮肤缺损,该方法皮瓣成活率高、不良反应少,原病变复发率低。

Objective To investigate the clinical curative effects of single advancement skin flap in repairing the medial cheek after resection of malignant tumor and precancerous lesions. Methods In total 12 cases,namely six cases of basal cell carcinoma,one case of actinic keratosis with highly differentiated squamous carcinoma,one case of squamous carcinoma,four cases of actinic keratosis. The lesion borders were excised with 4 mm,4 mm,4 mm and 3 mm additional margin respectively. Then defects were repaired with the single advancement flap. The length of flap was about twice as the width of the starting position of the flap. Soft tissue flaps were elevated from superficial layer of SMAS. Results After operation,all flaps survived well. The aesthetic and functional results were satisfactory and no one relapsed after seven months follow-up. Conclusion It is confirmed that the single advancement flap can be employed to reconstruct certain size of defects after resection of malignant tumor or precancerous lesion located on the medial cheek. The flap survival rate is high,and the original disease recurrence rate is lower with less side effects.