头部O-Z皮瓣的设计及其临床应用研究  

The design and clinical applications of the scalp O-Z flap

作　　者：王扬剑[1] 郑雪红[1] 华祖广 叶朝辉[1] 任甜甜[1] 宋庆华 魏鹏[1] Wang Yangjian;Zheng Xuehong;Hua Zaguang;Ye Zhaohui;Ren Tiantian;Song Qinghua;Wei Peng(Department of Plastic Surgery,Ningbo First Hospital,Ningbo 315010,China)

机构地区：[1]宁波市第一医院整形修复重建外科,315010

出　　处：《中华整形外科杂志》2018年第12期1033-1037,共5页Chinese Journal of Plastic Surgery

基　　金：宁波市科技惠民项目(2017C50064).

摘　　要：目的探讨应用O-Z皮瓣修复头皮肿瘤切除后圆形或椭圆形创面缺损的临床疗效。方法将头皮肿瘤做圆形或椭圆形根治性切除,术中对可疑恶性肿瘤行快速冰冻切片明确诊断,同时确保切缘阴性。根据创面缺损的大小、部位及其周围头皮的松动性、头发分布情况,在创面左右侧或前后方形成2个方向相反的旋转皮瓣,并将其相对旋转修复创面。结果2016年4月至2017年11月,共收治6例头皮肿瘤患者,其中2例为基底细胞癌,2例为鳞状细胞癌,1例为毛鞘癌,1例为表皮样囊肿。肿瘤完整切除后创面缺损面积为3.0cm×3.5cm^5.0cm×6.0cm。术后1例皮瓣尖端发生约6%的坏死,经换药等对症治疗4周后完全愈合,其余皮瓣均成活,无并发症发生。所有病例随访3~12个月,头皮形态良好,未见肿瘤复发。结论头部O-Z皮瓣设计灵活,操作方便,可有效同期修复头皮肿瘤根治术后中小面积缺损,术后头发生长良好,外形满意。Objective To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal.Methods The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion.Results From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed.Conclusions The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.

关 键 词：缺损 皮瓣 头皮肿瘤 

分 类 号：R622[医药卫生—整形外科]