改良菱形皮瓣在面部皮肤软组织缺损修复中的应用  

The application of modified rhomboid flap in repairing facial skin and soft tissue defect

作　　者：黄娜 文辉才[1] 付建华[1] 黄进军 廖怀伟[1] 涂峻 卢颖洁[1] 祝愿 蒯权 HUANG Na;WEN Huicai;FU Jianhua;HUANG Jinjun;LIAO Huaiwei;TU Jun;LU Yingjie;ZHU Yuan;KUAI Quan(Department of Plastic Surgery,the First Affiliated Hospital of Nanchang University,Nanchang ]iangxi,330006,P.R.China)

机构地区：[1]南昌大学第一附属医院整形美容科,南昌330006

出　　处：《中国修复重建外科杂志》2019年第2期207-211,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨改良菱形皮瓣修复面部皮肤软组织缺损的临床效果。方法 2016年1月—2018年5月,应用改良菱形皮瓣修复面部皮肤软组织缺损23例。男10例,女13例;年龄11～72岁,中位年龄27岁。原发肿瘤:色素痣18例,基底细胞癌4例,鳞状细胞癌1例。缺损部位:鼻部8例,颊部4例,颧部6例,额部2例,上唇部3例;缺损范围0.8 cm×0.8 cm～3.9 cm×3.9 cm。根据面部肿瘤部位、大小设计正方形病灶切除范围,根据周边组织移动性及皮纹方向,设计角度为45～60°的菱形皮瓣供区,无张力旋转修复缺损。结果术后皮瓣均成活,切口均Ⅰ期愈合。23例患者均获随访,随访时间3～15个月,平均7.3个月。随访期间肿瘤均无复发,皮瓣颜色、质地与周边组织相似,无明显瘢痕增生,邻近正常组织无牵拉,患者满意度高。结论应用改良菱形皮瓣修复面部圆形肿瘤切除后缺损创面,具有设计灵活、操作简便、创伤小等优点。Objective To explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect. Methods Between January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years(range, 11-72 years). The primary tumor included pigmented nevus in 18 cases, basal cell carcinoma in 4 cases, and squamous cell carcinoma in 1 case. The defect location was nose in 8 cases, cheek in 4 cases, malar in 6 cases, forehead in 2 cases, and upper lip in 3 cases. The defect ranged from 0.8 cm×0.8 cm to 3.9 cm×3.9 cm. According to the location and size of facial tumors, the resection area of square lesions was designed. According to the mobility of surrounding tissues and the direction of dermatoglyphic lines, the rhomboid flaps with an angle of 45–60° was designed to repair the defect by tension-free rotation. Results All the flaps survived and the incision healed by first intension. All patients were followed up 3-15 months(mean, 7.3 months). During follow-up, no tumor reoccurred;the color and texture of the flaps were similar with surrounding tissue. There was no obvious scar hyperplasia, nor traction of adjacent normal tissues, and patients were satisfied with the appearance. Conclusion The application of modified rhomboid flaps in repairing facial skin and soft tissue defects caused by resection of round facial tumor has the advantages of flexible design, simple manipulation, and less trauma.

关 键 词：改良菱形皮瓣 面部皮肤缺损 创面修复 面部 

分 类 号：R622[医药卫生—整形外科]