面动脉穿支皮瓣修复鼻、唇与颊部皮肤软组织缺损  

Reconstruction of soft tissue defects at nose, lip, and cheek with facial artery perforator flaps

作　　者：张培培[1,3] 杨超[1] 邢新[1] 戴海英[1] 郭伶俐[2] 吕文亮 

机构地区：[1]全军整形外科中心、第二军医大学附属长海医院整形外科,上海200433 [2]解放军总医院整形修复外科 [3]解放军第455医院整形外科 [4]解放军总参管理保障部机关门诊部

出　　处：《中华整形外科杂志》2016年第1期35-38,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨面动脉穿支皮瓣修复鼻、唇与颊部皮肤软组织缺损的临床效果。方法根据缺损的部位、大小、形状，应用多普勒超声血流探测仪确定最靠近缺损处部位的面动脉穿支血管，并以其从面动脉发出的位置为旋转点设计面动脉穿支蒂皮瓣修复创面。皮瓣大小与缺损面积相近，形成皮瓣时在不妨碍皮瓣转移的情况下尽可能多地保留穿支血管周围的皮下脂肪，以避免静脉回流障碍。结果2012年10月至2013年10月，共应用面动脉穿支皮瓣修复面部皮肤软组织缺损26例，其中鼻部缺损9例，上唇部缺损10例，颊部缺损7例，缺损面积1．5cm× 2．0cm-3．0cm×3．0cm，皮瓣切取面积2．0cm×2．5cm～3．5cm×3．5cm。术后除1例皮瓣远端发生3mm宽的表层坏死外，其余25例皮瓣均完全成活。16例获得3个月至2年随访，肿瘤无复发，功能与外形满意。结论面动脉穿支皮瓣修复鼻、唇与颊部中等大小的皮肤软组织缺损安全可靠，可获得理想的功能与外形效果。Objective To investigate the therapeutic effect of facial artery perforator flap for the soft tissue defects at nose, lip and cheek. Methods The facial artery perforator adjacent to the defect was identified by Doppler uhrasonography. The perforator flap was designed according to the defect location, size and shape. The subcutaneous tissue around the perforator was kept as much as possible to protect the venous drainage. Results From Oct. 2012 to Oct. 2013, 26 cases were treated with facial artery perforator flaps, with 9 cases of nasal defects, 10 cases of lip defects and 7 cases of buccal defects. The defects size ranged from 1.5 cm ×2.0 cm to 3.0 cm × 3.0 cm and the flaps size ranged from 2.0 cm ×2.5 cm to 3.5 cm ×3.5 cm. Superficial necrosis（3mm in width） happened at the end of one flap. All the other 25 flaps survived completely. 16 cases were followed up for 3 months to 2 years with no relapse and satisfactory cosmetic and functional results were achieved. Conclusions Both cosmetic and functional effect can be achieved with facial artery perforator flap for defects at nose, lip and cheek.

关 键 词：面动脉 穿支皮瓣 面部 

分 类 号：R622[医药卫生—整形外科]