梳子瓣技术和步序设计理念在整形美容与修复重建中的应用  

Comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery

作　　者：高玮 林晓曦[1,2] 邹运[2] 仇雅璟[2] 陈辉[2] 胡丽[2] 常雷[2] 金云波[2] 华晨[2] Gao Wei;Lin Xiaoxi;Zou Yun;Qiu Yajing;Chen Hui;Hu Li;Chang Lei;Jin Yunbo;Hua Chen(Department of Laser and Aesthetic Medicine,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院激光美容科,上海200011 [2]上海交通大学医学院附属第九人民医院整复外科,上海200011

出　　处：《中华整形外科杂志》2024年第3期286-292,共7页Chinese Journal of Plastic Surgery

基　　金：上海交通大学医学院附属第九人民医院生物样本库项目(YBKA202209);上海交通大学医学院附属第九人民医院基础研究助推计划资助(JYZZ227)。

摘　　要：目的探讨梳子瓣技术和步序设计理念在整形美容与修复重建手术中的应用效果及适用性。方法回顾性分析2018年1月至2022年12月上海交通大学医学院附属第九人民医院应用梳子瓣技术行整形美容与修复重建手术患者的临床资料。梳子瓣技术在应用过程中遵循步序设计的理念,即分步、按序进行术前、术中的设计和调整,将设计与手术步骤相结合。其主要操作包括:沿目标区域边缘设计切口并切开,在目标区域基底部广泛分离形成组织瓣,垂直于切缘方向对组织瓣按序裁切并临时缝合固定,边裁切边固定,期间可对切口张力和局部外观进行调整,整个组织瓣分割后形成梳子样外观,沿着临时固定点对整个梳子瓣进行切除,精细缝合切缘,最后拆除临时缝线。术后对患者手术切口愈合情况、并发症等进行观察,对患者面部恢复情况和手术效果进行随访。结果共纳入6例患者,男3例,女3例,年龄2~58岁。其中1例行眉下切口上睑提紧术及睑缘切口下睑成形术,1例行中下面部除皱术,1例行厚唇修薄及右面部抽脂术,1例行面部先天性黑色素痣切除术,1例行眉部先天性黑色素痣切除术,1例行面部皮瓣修整术。患者术后切口均一期愈合,未出现手术相关并发症。术后随访3~18个月,患者面部均恢复良好,对手术效果均表示满意。结论将梳子瓣技术及歩序设计理念应用于整形美容与修复重建手术中,可精细调整切缘的对合,使切口张力均匀分布,降低术后切口瘢痕形成及外观畸形的风险;其临床应用范围广泛,有较好的适用性。Objective To explore the clinical outcome and applicability of the comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery.Methods The clinical data of patients who underwent plastic aesthetic and reconstructive surgery with the comb flap technique in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2022 were retrospectively analyzed.The application of the comb flap technique follows the concept of stepwise design,that was,preoperative and intraoperative design and adjustment were carried out step by step and in sequence,and the design was combined with the surgical procedure.Its main operations included:an incision was designed along the edge of the target area,the tissue flap was widely separated at the base of the target area.The tissue flap was cut in sequence perpendicular to the cutting edge and temporarily sutured and fixed,the edge was cut and fixed.During the operation,the tension of the incision and the local appearance could be adjusted.The incisal edge was finely sutured,and the temporary suture was finally removed.The healing of surgical incision and complications were observed after the operation,and the facial recovery and surgical effect were followed up.Results Six patients were enrolled,including 3 males and 3 females,aged from 2 to 58 years.One patient underwent upper eyelid tightening and lower eyelid blepharoplasty through subeyebrow incision.One patient underwent middle and lower face rhytidectomy.One patient underwent thick lip thinning and right facial liposuction.One patient underwent facial congenital melanocytic nevi resection.One patient underwent eyebrow congenital melanocytic nevus resection.One patient underwent facial flap repair.All patients had primary healing of incision,and no surgery-related complications occurred.All patients were followed up for 3 to 18 months,and all patients were satisfied with the surgical effect.Conclusion The application of comb flap te

关 键 词：外科皮瓣 美容外科 整形外科 梳子瓣 步序设计 

分 类 号：R622[医药卫生—整形外科]