PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperativ...PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperative period. METHODS: In this prospective, randomized study, 68 of 70 patients were followed for a mean of 29.22 (range, 6- 44) months after wide excision plus classic Limberg flap (Group 1, n = 35) and after asymmetric modified Limberg flap closure (Group 2, n = 33). RESULTS: There were significantly more macerations in Group 1 (P < 0.001). All macerations were detected on the lower part of the incision left on the intergluteal sulcus, and infections occurred subsequent to maceration. The infection rate was statistically higher in Group 1 than in Group 2 (P = 0.028). We noted that as a result of these complications, time to suture removal (P = 0.001), discharge from hospital (P = 0.001), and time off from work (P = 0.001) were significantly longer for Group 1 than for Group 2. There were two recurrences in the inferior part of the suture line in Group 1 and none in Group 2, which showed no statistical difference (P = 0.493). CONCLUSIONS: The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.展开更多
文摘目的:观察Li mber g皮瓣修复面部缺损创面的效果。方法:9例面部肿物切除后皮肤软组织缺损患者设计Li mber g皮瓣修复创面。其中肿瘤患者3例;色素痣患者6例。结果:9例患者术后皮瓣均未出现动脉供血和静脉回流障碍,皮瓣色泽、质地较好;伤口Ⅰ期愈合,随访3～6月未见肿物或色素痣复发,瘢痕不明显,形态满意。结论:Li mberg皮瓣修复面部中小缺损创面效果良好。设计原则包括:将旋转瓣设计在临近皮肤最松弛区域并且最好完整覆盖一个凸出的美学单位;如果局部旋转后发生猫耳畸形,可以使用皮下蒂皮瓣或者改良的Li mber g皮瓣(DuFour ment el皮瓣);如缺损为圆形,用阅读者皮瓣(t he r eadi ng manpr ocedur e)效果可能更好。
文摘PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperative period. METHODS: In this prospective, randomized study, 68 of 70 patients were followed for a mean of 29.22 (range, 6- 44) months after wide excision plus classic Limberg flap (Group 1, n = 35) and after asymmetric modified Limberg flap closure (Group 2, n = 33). RESULTS: There were significantly more macerations in Group 1 (P < 0.001). All macerations were detected on the lower part of the incision left on the intergluteal sulcus, and infections occurred subsequent to maceration. The infection rate was statistically higher in Group 1 than in Group 2 (P = 0.028). We noted that as a result of these complications, time to suture removal (P = 0.001), discharge from hospital (P = 0.001), and time off from work (P = 0.001) were significantly longer for Group 1 than for Group 2. There were two recurrences in the inferior part of the suture line in Group 1 and none in Group 2, which showed no statistical difference (P = 0.493). CONCLUSIONS: The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.
