局部皮瓣在二期修整再造鼻翼中的应用  

Application of local skin flaps in adjustment of reconstructed nasal alars at second stage

作　　者：蒋治远 游晓波 蔡震[2] 刘全[2] 唐贶昀[2] 张寒[2] 崔玮[2] 陈再洪 罗姗 

机构地区：[1]西南医科大学研究生院,四川泸州646000 [2]四川省医学科学院.四川省人民医院整形外科,成都610072

出　　处：《中国修复重建外科杂志》2018年第1期55-58,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨V-Y成形及Z成形等局部皮瓣二期修整再造鼻翼的疗效。方法 2012年6月—2017年1月,收治14例因鼻翼缺损行鼻唇沟皮瓣或额部扩张皮瓣修复术后患者。男9例,女5例;年龄18~52岁,平均34.8岁。该次手术距一期手术时间为1~12个月,平均3个月。根据一期再造鼻翼不同缺陷,选择V-Y成形5例、Z成形2例、V-Y成形+Z成形7例。结果患者均顺利完成手术。术后3例皮瓣远端表皮部分坏死,经换药后愈合,余均Ⅰ期愈合。患者均获随访,随访时间6~40个月,平均12个月。鼻翼外形良好,与健侧基本对称;鼻翼皮肤颜色、质地与周围正常皮肤接近。结论鼻翼缺损修复再造后,二期运用V-Y成形、Z成形等局部皮瓣修整鼻翼,可使再造的鼻翼形态更佳。Objective To investigate the effectiveness of local skin flaps such as V-Y advancement flap（V-Y plasty） and transposition flap（Z plasty） in the adjustment of reconstructed nasal alars at second stage. Methods Between June 2012 and January 2017, 14 cases of reconstructed nasal alars by nasolabial flap or expanded forehead flap were recruited. There were 9 males and 5 females with an average age of 34.8 years（range, 18-52 years）. The interval time between one-and two-stage operations was 1-12 months（mean, 3 months）. The type of local skin flap was decided according to the flaws of reconstructed nasal alars. V-Y plasty was used in 5 cases, Z plasty in 2 cases, and V-Y plasty combined with Z plasty in 7 cases. Results All operations were successfully completed. The flaps in 3 cases suffered from epidermal necrosis at the far end and healed by dressing change. The other wounds healed by first intention. All 14 cases were followed up 6-40 months（mean, 12 months）. The nasal alars had verisimilar shape and symmetrical appearance. The color and texture of reconstructed nasal alar were closed to peripheral tissues. Conclusion Applying local skin flaps such as V-Y plasty and Z plasty can acquire a better shape in the adjustment of reconstructed nasal alars.

关 键 词：鼻翼缺损 局部皮瓣 V-Y成形 Z成形 再造 

分 类 号：R622[医药卫生—整形外科]