颞浅动脉复合穿支皮瓣修复颞区皮肤软组织缺损并重建鬓角  

Superficial temporal artery composite perforator flap in repair of temporal skin and soft tissue defects and reconstruction of sideburns

作　　者：刘梅君 聂开瑜 胡鹏 魏在荣 王达利 曾雪琴 LIU Meijun;NIE Kaiyu;HU Peng;WEI Zairong;WANG Dali;ZENG Xueqin(Department of Burn and Plastic Surgery,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou,563003,P.R.China)

机构地区：[1]遵义医科大学附属医院整形外科,贵州遵义563003

出　　处：《中国修复重建外科杂志》2020年第4期493-496,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81360295);贵州省科技厅联合基金[黔科合成果2019(4441号)]。

摘　　要：目的探讨应用颞浅动脉复合穿支皮瓣修复颞区皮肤软组织缺损并重建鬓角的可行性及疗效。方法2018年1月—2019年1月,收治颞区肿瘤患者12例。男5例,女7例;年龄37~68岁,平均51岁。基底细胞癌8例,鳞状细胞癌4例。病程3个月~4年,平均13个月。肿瘤切除后遗留创面范围为3.8 cm×2.5 cm^5.2 cm×3.5 cm。设计颞浅动脉复合穿支皮瓣,其中带毛发的颞浅动脉额支穿支皮瓣修复有毛发生长区域并重建鬓角,切取范围为2.5 cm×1.0 cm^4.2 cm×3.0 cm;不带毛发的颞浅动脉下行支穿支皮瓣修复无毛发区域软组织缺损,切取范围为2.5 cm×1.5 cm^7.5 cm×4.0 cm。供区直接拉拢缝合。结果术后皮瓣均成活,供受区切口均Ⅰ期愈合。11例患者获随访,随访时间6~12个月,平均9个月。术区切口隐蔽,皮瓣平整,色泽与周围组织无明显差异,重建鬓角毛发走行与健侧一致,面部外观满意。随访期间局部肿瘤均无复发。结论针对颞区累及鬓角的皮肤软组织缺损,应用颞浅动脉复合穿支皮瓣可分区修复具有不同美学特征的亚单位,手术操作简便,术后外观满意,且对供区影响较小。Objective To investigate the feasibility and effectiveness of repairing temporal skin and soft tissue defects and reconstructing sideburns with superficial temporal artery composite perforator flap.Methods Between January 2018 and January 2019,12 patients with temporal tumors were treated.There were 5 males and 7 females with an average age of 51 years(range,37-68 years).There were 8 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma.The disease duration ranged from 3 months to 4 years(mean,13 months).The area of residual wound after tumor resection was 3.8 cm×2.5 cm-5.2 cm×3.5 cm.The superficial temporal artery composite perforator flap was designed.The hairy superficial temporal artery frontal branch perforator flap was used to repair the hair growing area and reconstruct the sideburn;and the area of the flap was 2.5 cm×1.0 cm-4.2 cm×3.0 cm.And the superficial temporal artery descending branch perforator flap without hair was used to repair the hair-free area;and the area of the flap was 2.5 cm×1.5 cm-7.5 cm×4.0 cm.The donor sites were sutured directly.Results All flaps survived,and the incisions at the donor and recipient sites healed by first intention.Eleven patients were followed up 6-12 months(mean,9 months).The incisions were not obvious.The flaps were flat and the color of the flaps were not significantly different from the surrounding skin.The reconstructed sideburns were consistent with the healthy side and the facial appearance was satisfactory.No local tumor recurred during follow-up.Conclusion For the temporal skin and soft tissue defects involving the sideburn,the superficial temporal artery composite perforator flap can be used to repair subunits with different aesthetic characteristics in sections and has the advantages of operating simply,obtaining satisfied facial appearance,and little effect on the donor site.

关 键 词：颞浅动脉 复合穿支皮瓣 颞区 鬓角重建 创面修复 

分 类 号：R622[医药卫生—整形外科]