扩张额部岛状皮瓣眼窝再造的临床研究  

RECONSTRUCTION OF CONTRACTED EYE SOCKET USING EXPANDED FOREHEAD ISLAND SKIN FLAP

作　　者：蔡震[1] 蒋海越[1] 国冬军[1] 潘博[1] 庄洪兴[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院外耳再造中心,北京100041

出　　处：《中国修复重建外科杂志》2007年第8期847-849,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨应用扩张额部带滑车上动脉与眶上动脉血管蒂的岛状皮瓣进行眼窝再造的可行性。方法2002年6月～2005年6月收治6例眼窝缺失患者,男4例,女2例;年龄16～42岁。受伤原因为外伤3例,肿瘤2例,化学烧伤1例。左侧4例,右侧2例。病程1～4年,均先行额部皮瓣供区皮肤软组织扩张术,1个月后行二期扩张后的额部带滑车上动脉与眶上动脉血管蒂的岛状皮瓣移位眼窝再造术。皮瓣切取范围8cm×5cm～10cm×6cm,术后观察再造眼窝外观及功能恢复效果。结果术后6例移位皮瓣全部成活,皮瓣无明显回缩,感觉功能良好。术后1个月义眼放置再造眼窝,位置稳定,无脱出现象;获随访1～3年,外观效果满意,皮瓣供区愈合良好,无明显瘢痕增生。结论应用扩张的额部带滑车上动脉与眶上动脉血管蒂的岛状皮瓣再造眼窝,皮瓣成活率高,再造眼窝外观、感觉及功能效果好,是一种较理想的眼窝再造方法。Objective To investigate the feasibility of reconstruction of the contracted eye socket by an application of the expanded forehead island skin flap with the supratrochlear and supraorbital arteries. Methods From June 2002 to June 2005, 6 patients with the eye socket defects were treated with an expanded forehead island skin flap with the supratrochlear and supraorbital arteries. There were 4 males and 2 females, aged 16-42 years. The.defects were caused by tumors in 2 patients, by trauma in 3, and by chemical burns in 1 ; the defects were in the left eyes of 4 patients and in the right eyes of the remaining 2 patients, with the illness course of 1 year to 4 years. All the patients first underwent the skin and soft tissue expanding operation on the donor forehead skin area; 1 month later, the transplant of the expanded forehead island skin flap with the supratrochlear and supraorbital arteries was performed to reconstruct the eye sockets. The flaps ranged in size from 8 cm×5 cm to 10 cm×6 cm. The appearance and functional recovery of the reconstructed eye sockets were observed after operation. Results The follow-up of all the patients for 1-3 years revealed that the skin flaps survived, with no visible contracture, and the fine sensory function was still present. The artificial eyes could be steadily placed in the reconstructed eye sockets. The donor areas were healed with no visible hyperplastic scars. Conclusion Reconstruction of the eye socket with an expanded forehead island skin flap with the supratrochlear and supraorbital arteries is a feasible, effective and simply method, and the patient can have a concealed incision, a satisfactory appearance, and a fine sensory function.

关 键 词：眼窝再造 滑车上动脉 眶上动脉 扩张岛状皮瓣 

分 类 号：R779.6[医药卫生—眼科]