推进皮瓣在美学修复面部皮肤缺损中的应用  

Application of advancement flap in aesthetic repair of facial skin defects

作　　者：曹原 王子茂 王琪影[1] CAO Yuan;WANG Zimao;WANG Qiying(Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院整形外科,河南郑州450052

出　　处：《中国现代医生》2021年第31期88-93,共6页China Modern Doctor

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190143)。

摘　　要：目的研究单蒂推进皮瓣、A-T皮瓣和风筝皮瓣在面部较小面积皮肤缺损中的美学修复效果。方法将2016年1月至2020年3月本院整形外科收治的61例面部皮肤肿瘤患者纳入本回顾性研究。对面部皮肤病变切除术后形成的缺损创面,根据面部缺损部位和大小、周围组织和皮肤张力、手术切口的隐蔽性等因素综合分析与考量,设计合适的推进皮瓣进行美学修复,并于术后随访,比较三种推进皮瓣的SCAR量表评分、三种推进皮瓣的美容效果分级和评分、不同年龄段的美容评分及不同面积面部缺损的美容评分。结果61例患者的手术切口均一期愈合,皮瓣全部成活。三种皮瓣的眼睑部、眉部、唇部瘢痕评分比较,差异无统计学意义(P>0.05);三种皮瓣的鼻部瘢痕评分比较,差异有统计学意义(P<0.05)。三种皮瓣的美容效果分级、美容效果总平均评分及在面部不同部位的美容评分比较,差异无统计学意义(P>0.05)。本研究三个年龄段的美容评分比较,差异有统计学意义(P<0.05)。本研究四组不同缺损面积的美容评分比较,差异有统计学意义(P<0.05)。结论对于面部较小面积的皮肤缺损创面,术者应考虑面部缺损的部位、创面的深度和形状、缺损面积、周围皮肤的松弛程度、皮纹方向等情况,灵活巧妙地设计单蒂推进皮瓣、A-T皮瓣、风筝皮瓣进行美学修复,均能取得较理想的面部功能与外形效果。Objective To study the aesthetic repair effect of single pedicle advancement flap,A-T skin flap,and kite skin flap in minor facial skin defects.Methods A total of sixty-one patients with facial skin tumors admitted to the Department of Plastic Surgery of our hospital from January 2016 to March 2020 were included in this retrospective study.For the defect wound formed after resection of facial skin lesions,according to the comprehensive analysis and consideration of factors such as facial defect site and size,surrounding tissue and skin tension,and concealment of the surgical incision,an appropriate advancement flap was designed for aesthetic repair.And follow-ups after surgery were performed.The SCAR scale scores of the three kinds of advancing flaps,the grading and grading of the cosmetic effects of the three kinds of advancing flaps,the cosmetic scores of the different age groups and the cosmetic scores of the different areas of facial defects were compared.Results The surgical incisions of 61 patients healed primarily,and all flaps survived.There was no significant difference in the eyelid,eyebrow,and lip scar scores among the three kinds of skin flap(P>0.05).There was a significant difference in the nasal scar scores among the three kinds(P<0.05).There was no significant difference in the cosmetic effect grade,total average cosmetic effect score,and cosmetic score in different parts of the face among the three kinds(P>0.05).There was a significant difference in cosmetic scores among the three age groups(P<0.05).There were significant differences in the cosmetic scores of different defect areas among the four groups(P<0.05).Conclusion For the skin defect wound with a small area on the face,the surgeon should consider the location of the facial defect,the depth and shape of the wound,the defect area,the degree of laxity of the surrounding skin,and the direction of the dermatoglyph.The flexible and clever design of single pedicle advancement flap,A-T skin flap,and kite skin flap for aesthetic repair can achieve

关 键 词：推进皮瓣 面部缺损 A-T皮瓣 风筝皮瓣 美学单位 

分 类 号：R622[医药卫生—整形外科]