上睑眼轮匝肌岛状皮瓣修复眼睑及眶周皮肤肿瘤切除后继发缺损28例回顾性分析  

Application of the upper eyelid orbicularis oculi myocutaneous island flap in repairing secondary defects after resection of eyelid and periorbital skin tumors:a retrospective analysis of 28 cases

作　　者：岳超 段梦莹 王涛[1] 章满玉 戴叶芹[1] 彭建中[1] 宋秀祖[1] Yue Chao;Duan Mengying;Wang Tao;Zhang Manyu;Dai Yeqin;Peng Jianzhong;Song Xiuzu(Department of Dermatology,Hangzhou Third People′s Hospital,Hangzhou 310009,China;China Academy of Art,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院皮肤科,杭州310009 [2]中国美术学院,杭州310009

出　　处：《中华皮肤科杂志》2023年第9期862-865,共4页Chinese Journal of Dermatology

摘　　要：目的总结分析上睑眼轮匝肌岛状皮瓣修复眶周皮肤肿瘤切除后继发缺损的效果。方法回顾性分析2019年8月至2021年6月杭州市第三人民医院皮肤科应用上睑眼轮匝肌岛状皮瓣修复眼睑及眶周皮肤缺损的28例患者的临床资料,包括术后皮瓣成活情况以及上眼睑与眶周皮肤外观及肿瘤复发情况。结果28例中,男6例,女22例;年龄47~87(70.5±10.9)岁,80~89岁患者7例,70~79岁8例,60~69岁8例,50~59岁4例,40~49岁1例;皮肤缺损分布在上眼睑1例、下眼睑9例、内眦1例、外眦3例、眉上1例、鼻背3例,鼻部外侧与内眦、下睑交界区10例;缺损面积为0.5 cm×1.0 cm~2.3 cm×3.1 cm。设计的上睑眼轮匝肌皮瓣宽0.5~1.8 cm,长3~4 cm,皮下隧道长1.2~2.5 cm。在6个月至1.5年的随访时间内,皮瓣全部存活;上睑供瓣区瘢痕不明显;术后无上睑外翻,无倒睫,无闭合功能障碍。结论上睑眼轮匝肌岛状皮瓣可以成功修复眼睑及眶周皮肤中、小缺损,并具有良好的美容效果,供瓣区隐蔽。Objective To summarize and analyze the efficacy of the upper eyelid orbicularis oculi myocutaneous island flap in repairing secondary defects after resection of eyelid and periorbital skin tumors.Methods A retrospective analysis was carried out on clinical data collected from 28 patients,whose secondary eyelid and periorbital defects were repaired with the upper eyelid orbicularis oculi myocutaneous island flaps in the Department of Dermatology,Hangzhou Third People′s Hospital from August 2019 to June 2021.The survival condition of the flaps was observed after the operation,and the appearance of the upper eyelid and periorbital skin as well as tumor recurrence were evaluated during the follow up.Results Among the 28 cases,there were 6 males and 22 females;their ages ranged from 47 to 87 years(70.5±10.9 years),7 patients aged 80-89 years,8 aged 70-79 years,8 aged 60-69 years,4 aged 50-59 years,and 1 patient aged 40-49 years.Skin defects were distributed at the upper eyelid in 1 case,at the lower eyelid in 9 cases,at the inner canthus in 1 case,at the outer canthus in 3 cases,at the upper eyebrow in 1 case,at the dorsum of the nose in 3 cases,and at the junction of the external nose,inner canthus and lower eyelid in 10 cases.The skin defects varied from 0.5 cm×1.0 cm to 2.3 cm×3.1 cm in size.The designed upper eyelid orbicularis oculi myocutaneous flap was 0.5-1.8 cm in width and 3-4 cm in length,and the length of the subcutaneous tunnel was 1.2-2.5 cm.During the follow-up of 6 months to 1.5 years,all flaps survived;scars on the upper eyelid donor site were not obvious;there was no upper eyelid ectropion,no trichiasis,and no eyelid closure abnormality after the operation.Conclusion The medium-or small-sized defects of the eyelid and periorbital skin can be successfully repaired by the upper eyelid orbicularis oculi myocutaneous island flap,with a favorable cosmetic effect and concealed donor areas.

关 键 词：皮肤肿瘤 修复外科手术 外科皮瓣 眼睑 眼眶 眼轮匝肌 岛状皮瓣 

分 类 号：R739.5[医药卫生—肿瘤]