滑车上动脉皮支供血的额部薄皮瓣修复眉周皮肤缺损  

The clinical application of thin forehead flap supplied by cutaneous branch of supratrochlear artery in repairing defect of skin around eyebrow

作　　者：刘莹[1] 吕天琪 李宁[1] 车德惠 肖志波[1] Liu Ying;Lyu Tianqi;Li Ning;Che Dehui;Xiao Zhibo(Plastic Surgery Department of the 2nd Affiliated Hospital of Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院整形美容科,150081

出　　处：《中华整形外科杂志》2021年第11期1227-1231,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨滑车上动脉皮支供血的额部薄皮瓣经皮下隧道转移修复眉周皮肤缺损的临床效果。方法回顾性分析2017年6月至2019年6月,哈尔滨医科大学附属第二医院整形美容科收治的眉周皮肤病变患者。纳入标准:(1)眉周肿物,肿物大小在1.5 cm×2.0 cm~2.0 cm×3.0 cm之间;(2)病变无红肿、皮肤破溃、瘙痒及疼痛,术前根据患者病史及临床表现,初步诊断为良性病变,且病变周围组织良好,无炎症反应,术后病理回报也均为良性病变(色素痣、血管瘤等);(3)均行肿物切除术+滑车上动脉皮支供血的薄皮瓣转移修复手术;(4)意识清楚,无智力及认知障碍,对本研究知情同意且愿意配合术后随访。排除合并其他系统严重疾病者。在额部近发际线处设计滑车上动脉皮支供血的额部薄皮瓣,皮瓣大小、形状应与病变大小相近。术中切取额部皮瓣,皮下蒂内含滑车上动脉皮支血管,经皮下隧道将皮瓣转移修复缺损创面。术后通过观察皮瓣颜色等指标判断皮瓣成活情况,使用温哥华瘢痕量表(VSS)对瘢痕进行评价。结果共纳入15例患者,男2例,女13例,年龄12~44岁,缺损范围:1.5 cm×2.0 cm~2.0 cm×3.0 cm。皮瓣大小与缺损面积接近,术后皮瓣均成活良好,其中2例术后切口感染,给予抗炎治疗、每日换药后,切口愈合良好;5例发生局部表皮坏死,按时换药,形成血痂,血痂脱落后,3例无明显色素沉着,2例伴轻度色素沉着。术后随访12个月,VSS评分均在0~4分,患者均对术后效果表示满意。结论应用额部薄皮瓣经皮下隧道转移修复眉周皮肤缺损,可一期手术完成,皮瓣供区瘢痕位置隐蔽,对眉部及内眦无牵拉变形,皮瓣成活率高。Objective To investigate the clinical effect of subcutaneous tunnel transfer of forehead thin skin flap supplied by cutaneous branch of supratrochlear artery in repairing skin defect around eyebrow.Methods From June 2017 to June 2019,15 patients with eyebrow skin lesion were treated with the aforementioned method at the Plastic Surgery Department of the 2nd Affiliated Hospital of Harbin Medical University.Inclusion criteria:(1)The skin defect area ranged from 1.5 cm×2.0 cm to 2.0 cm×3.0 cm.(2)There was no redness,swelling,skin ulceration,pruritus or pain in the lesions.Based on the patient’s medical history and clinical manifestations before surgery,the lesions were preliminarily diagnosed as benign lesions,and the surrounding tissues of the lesions were good without inflammatory reaction.(3)All patients were treated with tumor resection and repair with thin flap supplied by the cutaneous branch of the supracrochlear artery.(4)Clear consciousness,no intellectual or cognitive impairment,informed consent to this study and willing to cooperate with postoperative follow-up.Patients with other serious systemic diseases were excluded.A thin frontal flap supplied by the cutaneous branch of the supratrochal artery was designed near the hairline of the forehead.The size and shape of the flap should be similar to the size of the lesion.During the operation,the frontal flap was elevated,and the subcutaneous pedicle contained the cutaneous branch of the supratrochlea artery,and the flap was transferred to repair the defect wound through the subcutaneous tunnel.After the operation,the skin flap survival was evaluated by observing the skin flap color and other indicators,and the scar was evaluated by the Vancouver Score Scale(VSS).Results A total of 15 patients were included,including 2 males and 13 females,aged 12-44 years,and the defect range was 1.5 cm×2 cm-2 cm×3 cm.The flap survived well after operation.In 2 cases,the incision was infected after operation,and the incision healed well after receiving anti-inflammator

关 键 词：外科皮瓣 修复外科手术 滑车上动脉 

分 类 号：R622[医药卫生—整形外科]