额部和面部联合扩张修复鼻部及下睑区病损切除后创面  

Combined pre-expansion of forehead and facial region for repairing tissue defects after removal of lesions in nose and facial area

作　　者：马显杰[1] 董立维[1] 李杨[1] 王璐[1] 李威扬[1] 

机构地区：[1]第四军医大学西京医院全军整形外科研究所,西安710032

出　　处：《中华医学美学美容杂志》2015年第4期205-207,共3页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家自然科学基金资助项目（81171826）、（81272117）;陕西省科学技术研究发展计划项目（2012SF2-01-2）

摘　　要：目的 探讨额部和面部联合扩张修复鼻部及下睑区病损切除后创面的临床效果.方法 据鼻部、下睑区病损面积大小,考虑额部、面部联合扩张方法,确定扩张器容量大小.额部在额肌下、骨膜上放置150～170ml扩张器,面部据正常组织面积在浅表肌腱膜系统（SMAS）筋膜浅层放置尽量大的扩张器.待扩张充分后,将鼻部、面部下睑区病损切除,松解后,面部设计直接推进或易位皮瓣转移,额部则以滑车上血管为蒂设计易位带蒂皮瓣转移修复鼻背及下睑区创面.额部带蒂皮瓣3周后断蒂,舒平修复剩余病损切除后创面.结果 6例皮瓣均全部成活,术后肤色佳,与面部匹配良好,无下睑外翻发生,取得了较满意的效果.结论 额部、面部联合扩张皮瓣是修复鼻部、面部下睑区病损的较好方法.Objective To investigate the treatment methods of tissue defects in nose and lower eyelid area.Methods Based on the impaired area,combined pre-expansion of forehead and facial region was adopted.The volume of soft tissue expander was determined.150-170 ml expander was implanted between frontalis muscle and periosteum of forehead,while at the facial region,and the volume of expander should be determined by the normal skin area as large as possible.The excision of impaired tissue was performed after sufficient expansion,and then skin flap or transposition skin flap were advanced at the facial region.At forehead,ortho-position skin flap based on supratrochlear vessels was designed for repairing the nose and palpebra inferior region.Three weeks later division of the ortho-position skin flap was carried out.With the flattened pedicle,the rest part of impaired area was replaced.Results Six cases were performed with this method.For all the cases,the survival rate of flap was 100%.Esthetic appearance and satisfying color-match were achieved,without appearance of lower eyelid ectropion.Conclusions Combined pre-expansion of forehead and facial region is an ideal method in treatment of the defects in nose and lower eyelid area.

关 键 词：面部 扩张术 皮瓣 

分 类 号：R622[医药卫生—整形外科]