烧伤后鼻部及邻位组织缺损畸形的修复  

Repair of nose and adjacent tissue defect deformities after burn

作　　者：张丕红[1] 黄晓元[1] 任利成[1] 龙剑虹[1] 范鹏举[1] 曾纪章[1] 肖目张[1] 

机构地区：[1]中南大学湘雅医院烧伤整形科,湖南长沙410008

出　　处：《中华烧伤杂志》2009年第6期419-421,共3页Chinese Journal of Burns

摘　　要：目的了解烧伤后鼻及邻位组织缺损的最佳修复方法及效果。方法1999年1月-2008年12月，笔者单位采用额部扩张皮瓣、上臂带蒂皮瓣、耳后反流轴型岛状皮瓣及鼻唇沟皮瓣，修复烧伤后鼻部及邻位组织缺损畸形患者12例，其中全鼻缺损4例，鼻部分缺损8例。12例患者中鼻缺损伴面颊部瘢痕3例，伴额部瘢痕5例，伴上唇外翻及上唇大部分缺损共5例。皮瓣面积3.0cm×1.5cm—10.0cm×8.0cm。结果采用额部扩张皮瓣修复5例、上臂带蒂皮瓣修复3例、耳后反流轴型岛状皮瓣修复1例、鼻唇沟皮瓣修复3例。12例皮瓣全部成活。随访1-7年，患者鼻的功能及外形均明显改善。结论额部皮瓣为修复烧伤后鼻缺损的首选皮瓣。面部严重烧伤，瘢痕明显，不能选择局部皮瓣或邻位皮瓣时，可考虑应用上臂带蒂皮瓣、耳后反流轴型岛状皮瓣等修复。Objective To look for the best method of repairing nose and adjacent tissue defect after burn and observe the effect. Methods Twelve patients with post-burn nose and adjacent tissue defect deformities hospitalized from January 1999 to December 2008 were repaired with expanded forehead flap, pedicled upper-arm flap, axial post-auricular reversed flow island flap, and nasolabial groove flap. Among them, 4 cases with total nasal defect, 8 cases with partial nasal defect; and 3 cases were accompanied with scars on cheek, 5 cases accompanied with scars on forehead, 5 cases accompanied with upper lip ectropion and sub- total upper lip defect. The skin flap size ranged from 3.0 cm×1.5 cm to 10.0 cm×8.0 cm. Results Five cases were repaired with expanded forehead flap, 3 cases with pedicled upper-arm flap, 1 case with axial post-auricular reversed flow island flap, and 3 cases with nasolabial groove flap respectively. All the 12 flaps survived. Patients were followed up for 1 to 7 years, and nasa/function and appearance were obviously improved. Conclusions Optimal repairing method shall be chosen to repair nasal defect after burn according to its extent, and forehead flap is preferred. Pedicled upper-arm flap and reversed flow axial post-auricular island flap can be employed if local flap and ortho-position skin flap are unavailable when obvious scar is present on face as a result of severe burn.

关 键 词：烧伤 鼻 面部损伤 外科皮瓣 修复 

分 类 号：R686[医药卫生—骨科学]