多个局部皮瓣联合修复鼻小柱与上唇瘢痕挛缩畸形  

Clinical Effect of Multiple Local Skin Flaps in Repairing Scar Contracture Deformity of Nasal Columella and Upper Lip

作　　者：逯艳 王振宇 裴洁 贺梦男 高晓博 王小兵[3] LU Yan;WANG Zhen-yu;PEI Jie;HE Meng-nan;GAO Xiao-bo;WANG Xiao-bing(The First Clinical Medical College of Shanxi Medical University of Shanxi Province,Taiyuan 030001,Shanxi,China;Department of Medical Cosmetology,Shanxi Academy of Medical Sciences,Shanxi Dayi Hospital,Taiyuan 030001,Shanxi,China;Department of Plastic Surgery,the First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030001 [2]山西医学科学院山西大医院医疗美容科,山西太原030001 [3]山西医科大学第一医院整形外科,山西太原030001

出　　处：《中国美容医学》2019年第9期56-59,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:观察多个局部皮瓣联合应用修复鼻小柱与上唇瘢痕挛缩畸形的美学效果。方法:针对鼻唇中央瘢痕粘连挛缩引起的上唇外翻及鼻小柱短缩畸形,在上唇瘢痕区设计局部瘢痕瓣,将其向上推进重塑鼻小柱外形;在鼻小柱侧面分别设计"U"形皮瓣,将其旋转至鼻小柱下方形成对合皮瓣,重建鼻小柱基底;红唇缘复位后残留创面根据其大小分别选用直接缝合、游离皮片移植或下唇交叉皮瓣等进行创面闭合,矫正上唇外翻畸形。结果:鼻小柱与上唇瘢痕挛缩畸形采用上述方法修复后鼻、唇均恢复其解剖位,唇外翻畸形矫正效果好,人中、唇峰、唇红线流畅,对称性好,鼻小柱延长效果显著,伤口均一期愈合;随访6~18个月发现术区瘢痕隐蔽,术后效果满意。结论:多个局部皮瓣联合应用在鼻小柱与上唇瘢痕挛缩畸形修复中可兼顾上唇外翻和鼻小柱短缩畸形,能最大程度恢复鼻唇区美学外观,值得临床推广应用。Objective To observe the aesthetic effect of multiple local flaps on repairing nasal columella and upper lip contracture deformity. Methods Design local flaps for patients with upper lip valgus deformity and the nasal columella shortening deformity caused by the contracture deformities, one local scar flap was designed in the upper lip scar area, we will push it up to reshape the nasal columella appearance. Two "U" flaps were designed on the side of the nasal columella, which was rotated to the bottom of the nasal columella to form involutive flap, the flap can reconstruct the base of the nasal columella. After reconstruct the Cupid bow, the remainingl wound can be closed by direct suture, free skin grafting or lower lip cross flap according to its size. Results The patients with nasal columella and upper lip contracture deformitys were repaired with the method mentioned above, after the treatment their nasal and labial were restored to normal anatomic position. The correction effect of the lip valgus deformity was good, the phiitrum lip peak and red line of the lip were all smooth and symmetric, and the nasal columella was extended. All wounds healed in the first stage. After 6 to 18 months of follow-up, we found that the surgical scars were concealed and the postoperative results were satisfactory. Conclusion The combined application of multiple local flaps in repairing of patients with nasal columella and upper lip contracture deformitys can correct both upper lip valgus and nasal columella shortening deformity, which can restore the aesthetic appearance of nasal lip region to the greatest extent. In summary, this method is worthy of being promoted and applied.

关 键 词：瘢痕瓣 对合皮瓣 鼻小柱 瘢痕挛缩 上唇外翻 

分 类 号：R622[医药卫生—整形外科]