鼻唇沟皮瓣的分类及其在鼻部创面修复中的应用  

The classification of nasolabial flaps and its application in repair of nasal defects

作　　者：薛春雨[1] 邢新[1] 郭伶俐[1] 李军辉[1] 张敬德[1] 

机构地区：[1]第二军医大学附属长海医院整形外科,上海200433

出　　处：《中国美容整形外科杂志》2010年第1期20-23,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨鼻唇沟皮瓣的分类及其在鼻部皮肤缺损创面修复的方法。方法根据鼻亚单位组成的美学原则，按鼻部皮肤软组织肿瘤切除后创面及创伤后皮肤缺损的部位、大小、深度及鼻唇沟区域组织可利用情况等，分别选择相应形式的鼻唇沟任意皮瓣转移修复鼻部缺损创面0．8cm×0．8cm～2．0cm×3．0cm，切取鼻唇沟皮瓣1．0cm×1.0cm～2．5cm×3．5cm。采用皮下蒂岛状鼻唇沟皮瓣者58例、改良菱形皮瓣者46例、“风筝”皮瓣者43例、易位皮瓣者9例、旋转皮瓣者11例，设计蒂在上方的鼻唇沟皮瓣109例，设计带在下方的鼻唇沟皮瓣58例，所有切取的皮瓣与创面大小匹配良好．结果本组167例患者，其中165例创面I期愈合；2例患者皮瓣远端部分表皮坏死，经局部换药后创面愈合。术后113例患行获随访1～60个月，鼻外形轮廓及视觉效果良好，修复组织与剧周皮肤组织在色泽、质地、轮廓、光化性损害程度等方面相匹配，鼻唇沟区切口搬痕不明显，获得满意的面部形态和美学效果．肿瘤无复发。结论遵循鼻亚单位美学原则，应用鼻唇沟任意皮瓣修复鼻部肿瘤切除及创伤后中等大小创面，不仅操作方便，面部形态无明显改变，而且修复再创面的皮肤色泽、质地、轮廓等均能与周围皮肤达到较好的匹配和协调，可获得满意的功能和稳定的美学效果．Objective To introduce the classification of nasnlabial flap and its application to the repair of nasal defects. Methods Based on the aesthetic subunit principle and according to the size, shape, location of nasal defects and the conditions of nasolabial skin, we selected homologous nasolabial flap （for instant： advanced flap, island subcutaneous pedicled nasolabial flap, rotation flap, reforming rhomboid flap and ＂kite＂ flap, et al. ） to cover the nasal defects caused from nasal tumor excision and trauma in 167 cases. The areas of the defects ranged from 0.8 cm× 0.8 cm to 2.0 cm× 3.0 cm. The sizes of designed flap ranged from 1.0 cm × 1.0 cm to 2.5 cm× 3.5 cm. The used nasolabial flaps included island subcutaneous pedicle nasolabial flaps （ 58 cases）, ＂kite＂ flap （43 cases）, rotation flap （11 cases）, reforming rhomboid flap （46 cases）, and transfer flap （9 cases）, Inferiorly pedicled nasolabial flap were 58 cases, superiorly pedicled nasolabial flap were 109 cases. Results A total of 167 patients with nasal defects due to tumor excision and trauma were treated by nasolabial flap transfers. Among 167, 165 cases have acquired complete recovery, the other 2 eases with epidermic necrosis at distal end of flap were healed by regional change dressings. The secondary defects of nasolabial area were directly sutured. Ahout 113 of 167 patients were followed up for 1 - 60 months, they were satisfied with concealed scar on nasolabial groove, the excellent facial contour and good repaired tissue which matched with surrounding tissue and no tumor recurrence. Conclusion Based on the nasal aesthetic subunit principle, nasolabial flap can be used to reconstruct the nasal medial defects with the advantages of easy operation, and repaired tissue with a good color, contour and texture which matched with the surrounding skin.

关 键 词：鼻唇沟皮辩 鼻皮肤肿瘤 鼻缺损 修复重建 

分 类 号：R628[医药卫生—整形外科]