颈侧扩张皮瓣联合乳突区皮瓣修复面部皮肤软组织缺损  

Expanded lateral neck flap combined with posterior auricular flap for facial skin defect

作　　者：汪雨 李养群 杨喆 唐勇 陈文 马宁 王维新 许砾思 Wang Yu;Li Yangqun;Yang Zhe;Tang Yong;Chen Wen;Ma Ning;Wang Weixin;Xu Lisi(Department of Plastic Surgery If, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院整形二科,北京100144

出　　处：《中华整形外科杂志》2018年第5期368-371,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨颈侧扩张皮瓣联合乳突区皮瓣修复面部皮肤软组织缺损的可行性。方法一期手术：将1枚200-600 ml的扩张器埋置于颈侧皮下、颈阔肌浅层，经2-3个月注水扩张形成扩张皮瓣。二期手术：以颈前部为蒂形成颈侧扩张皮瓣与耳后乳突区皮瓣的联合皮瓣，旋转修复侧面部创面。结果2009年1月至2016年11月于临床应用12例，扩张皮瓣面积为6 cm×12 cm-7 cm×15 cm，蒂部宽度6-7 cm。术后随访2个月至2年，平均10个月，2例皮瓣尖端出现静脉回流障碍，经积极换药1周，最终对皮瓣成活无影响，其余皮瓣均一期愈合，修复区外观和功能得到矫正，患者对手术效果满意。结论以颈前部为蒂的颈侧扩张皮瓣联合乳突区皮瓣，具有充足的皮肤软组织量和良好的血供，可以较好地修复侧面部皮肤缺损，且对供区影响小。Objective To explore the blood supply of expanded lateral neck flap combined with posterior auricular flap pedieled on anterior neek and the feasibility of this kind of flap for facial vulnus＇ resurfaeing. Methods At the first stage of the treatment, one rectangular expander was implanted in lateral neck in the subcutaneous pockets, overlying the platysma, the volume of the expander is about 200 - 600 ml. After 2 - 3 months inflation, the pre-expanded lateral neck flap combined with posterior auricular flap was advanced at the second stage of the operation, the flap was rotated to lateral face to resurface the vulnus defects located on anterior auricle. Results Twelve cases of facial wounds were included in this research from January 2009 to November 2016. The size of the expanded flaps were ranged from 6 cm×12 cm to 7 cm × 15 cm. According to 2 to 24 months follow-up postoperatively, 10 months in average, two flaps showed venous retardation at distal part of expanded flaps, which were recorvered with one-week dress changing after excoriation. The other ten flaps survived with good appearance and function. The flaps matched well to the recipient defects in terms of color, character and elasticity. The appearance and function of face and neck were ideally adjusted after treatment. Conclusions By expanding lateral neck skin overlying platysma, the expanded lateral neck flap combined with posterior auricular flap pedieled on anterior neck was obtained with high quality and maximum use of blood supply in the anterior neck, which guaranteed appearance and function of the donor area and the recipient area at the same time.

关 键 词：外科皮瓣 皮肤软组织扩张术 颈部 乳突区 皮肤缺损 侧面部 

分 类 号：R622[医药卫生—整形外科]