改良V-Y推进皮瓣在面部皮肤缺损修复中的应用  

Application of modified V-Y advancement flap for reconstruction of facial defect

作　　者：徐新江[1] 汤明明[1] 韩靓[1] 蒋斌[1] XU Xinjiang;TANG Mingming;HAN Liang;JIANG Bin(Department of Head and Neck Surgery,Cancer Hospital Affiliated to Nantong University,Nantong,226361,China)

机构地区：[1]南通大学附属肿瘤医院头颈外科,江苏南通226361

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第1期44-48,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨改良V-Y推进皮瓣在面部皮肤缺损修复中的临床应用效果。方法:38例面部皮肤肿瘤患者,依据病理类型、病变深度,选择个性化方案切除肿瘤。根据缺损部位、大小设计合适的V-Y推进皮瓣,一期修复皮肤缺损。其中经典皮下蒂V-Y推进皮瓣9例,改良皮下蒂V-Y推进皮瓣24例,穿支V-Y推进皮瓣5例。结果:38例患者中,34例一期愈合,2例皮瓣边缘部分坏死,局部修剪后换药愈合;局部感染2例,均经过短期换药后愈合。术后发生轻度睑外翻2例,口角移位1例。术后随访6~36个月,功能、外形恢复良好,1例局部复发,3例出现腮腺区淋巴结转移,再次行手术切除并补充放疗。结论:V-Y推进皮瓣经过改良设计,扩大了面部缺损修复范围,同时可获得良好的外形、功能的修复效果。Objective:To investigate the clinical effect of modified V-Y advancement flap for reconstruction of facial skin defect.Methods:Thirty-eight patients with facial skin tumors underwent individual tumor resection according to pathological type and lesion depth.Based on the defect site and size,appropriate V-Y advancement flap was designed to reconstruct the skin defect in one stage.There were 9 cases of classic subcutaneous tissue pedicle V-Y advancement flap,24 cases of modified subcutaneous tissue pedicle V-Y advancement flap and 5 cases of perforated V-Y advancement flap in our study.Results:Among the 38 patients,34 cases had primary healing.Two cases developed necrosis at the edge of the flap and healed after debridement.Local infection occurred in 2 cases,which healed after short-term dressing change.Postoperative mild eyelid ectropion occurred in 2 cases and oral horn displacement in 1 case.The patients were followed up for 6-36 months postoperatively,and the function and appearance recovered well.One case had local recurrence and 3 cases had parotid lymph node metastasis,which were removed again and supplemented with radiotherapy.Conclusion:The improved design of V-Y advancement flap can enlarge the scope of facial defect reconstruction,and achieve good appearance and function.

关 键 词：V-Y推进皮瓣 皮肤肿瘤 面部缺损 修复外科手术 

分 类 号：R782.2[医药卫生—口腔医学]