吻合静脉的颞浅动脉额支逆行岛状皮瓣修复眶周缺损  

A retrograde island flap pedicled on the frontal branch of superficial temporal artery with additional vein anastomosis for reconstruction of peri-auricular defects

作　　者：肖辉[1] 曾宁[1] 王海平[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院整形美容外科,武汉430030

出　　处：《中华整形外科杂志》2017年第3期175-179,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨逆行颞浅动脉额支为蒂的耳周皮瓣静脉淤滞的有效解决方法。方法2013年10月至2016年5月，收治5例眶周病变患者，均以颞浅动脉额支逆行耳周岛状皮瓣进行修复，皮瓣转移至受区后再吻合颞浅静脉顶支与颞中静脉。供区直接拉拢缝合。结果切取皮瓣面积为2cm×3cm～2cm×8cm，所有皮瓣术后均存活，无静脉淤滞出现，皮瓣色泽满意。其中有3例后期进行了皮瓣修薄术。术后随访6个月至2年，平均12．4个月，皮瓣早期存活良好，远期颜色、质地与眶周皮肤相近，修复效果满意。供区伤口愈合良好，瘢痕不明显。结论逆行颞浅动脉额支供血的耳周岛状皮瓣辅加静脉吻合，是修复眶周皮肤小缺损的较好选择，解决了静脉淤滞及皮瓣坏死的问题。Objective To investigate an effective method for solving the venous stasis in reverse peri-auricular flap pedicled on the frontal branch of superficial temporal artery （ STA）. Methods From October 2013 to May 2016, 5 patients with peri-orbital defects were reconstructed with a retrograde flap pedicled on the frontal branch of STA that incorporated additional venous anastomosis. The additional venous anastomosis was created between the parietal branch of STY （superficial temporal vein） and the middle temporal vein. The defects at donor sites were directly sutured. Results The size of flaps ranged from 2cm×3cm to 2cm×8cm. All flaps survived without venous stasis. Color and texture match of the flap were excellent . In three cases, flaps were thinned in secondary operation. During the follow-up period （6 months to 2 years, average of 12.4 months） , flaps survived well on early period. Excellent color and tissue match with peri-orbital tissue were achieved on later stage. The scar at the donor site was inconspicuous. Conclusions Retrograde island flaps pedicled on the frontal branch of superficial temporal artery with vein anastomosis has the advantages of robust blood supply, good texture, and color match, and acceptable donor mobidity, while avoiding the venous stasis and flap necrosis.

关 键 词：外科皮瓣 颞浅动脉额支 颞中静脉 静脉淤滞 静脉吻合 

分 类 号：R622[医药卫生—整形外科]