改良双叶皮瓣修复鼻前庭基底细胞癌术后创面一例

目的探讨改良双叶皮瓣修复鼻前庭基底细胞癌术后创面缺损的方法和疗效。方法设计由局部菱形皮瓣和鼻唇沟皮瓣组成改良双叶皮瓣,修复1例鼻前庭基底细胞癌患者术后创面缺损。结果术中缝合切口无明显张力,鼻外形无明显变化。术后皮瓣成活良好,随访1个月术区无畸形,上唇、鼻孔外形均正常。结论改良双叶皮瓣修复鼻前庭基底细胞癌术后皮肤缺损,效果良好。     

面部基底细胞癌的手术治疗方法选择

目的 探讨面部基底细胞癌适合的手术治疗方法.方法 收治面部基底细胞癌患者62例,病灶扩大切除后,根据缺损面积及所处面部区域分别采用不同的修复方法 (直接缝合6例、局部皮瓣转移38例、皮片移植27例)修复创面.结果　术后均一期愈合,外形满意,随访2～5年,未见复发.结论　面部基底细胞癌首选手术切除,选择适宜的手术修复方式,可取得理想的治疗和美容效果.     

局部皮瓣修复鼻部皮肤恶性小肿瘤术后缺损54例

目的 探讨鼻部下1/3皮肤恶性小肿瘤手术切除后皮肤软组织缺损的多种皮瓣修复方法和效果。方法 手术切除鼻部皮损,术中病理示无残癌组织后,根据鼻缺损的部位、大小、形状以及周围皮肤情况等我们选择双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等方法进行皮肤软组织缺损的修复。结果 鼻部皮肤恶性小肿瘤54例,基底细胞癌39例占72.22%,鳞状细胞癌9例占16.67%,角化棘皮瘤6例占11.11%。切除后的缺损均位于鼻部下1/3,长径均未超过2.0 cm,术中修复缺损选择双叶皮瓣20例,双侧旋转皮瓣2例,鼻唇沟皮瓣32例,术后皮瓣全部成活,未见鼻部明显变形。随访5年未见复发。结论 局部双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等修复鼻部下1/3长径未超过2.0 cm的皮肤恶性肿瘤切除后的皮肤软组织缺损,可以获得较满意效果。     

局部皮瓣修复鼻部皮肤恶性小肿瘤术后缺损54例

目的 探讨鼻部下1/3皮肤恶性小肿瘤手术切除后皮肤软组织缺损的多种皮瓣修复方法和效果.方法 手术切除鼻部皮损,术中病理示无残癌组织后,根据鼻缺损的部位、大小、形状以及周围皮肤情况等我们选择双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等方法进行皮肤软组织缺损的修复.结果 鼻部皮肤恶性小肿瘤54例,基底细胞癌39例占72.22%,鳞状细胞癌9例占16.67%,角化棘皮瘤6例占11.11%.切除后的缺损均位于鼻部下1/3,长径均未超过2.0 cm,术中修复缺损选择双叶皮瓣20例,双侧旋转皮瓣2例,鼻唇沟皮瓣32例,术后皮瓣全部成活,未见鼻部明显变形.随访5年未见复发.结论 局部双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等修复鼻部下1/3长径未超过2.0 cm的皮肤恶性肿瘤切除后的皮肤软组织缺损,可以获得较满意效果.     

局部皮瓣修复鼻部皮肤恶性小肿瘤术后缺损54例

目的 探讨鼻部下1/3皮肤恶性小肿瘤手术切除后皮肤软组织缺损的多种皮瓣修复方法和效果.方法 手术切除鼻部皮损,术中病理示无残癌组织后,根据鼻缺损的部位、大小、形状以及周围皮肤情况等我们选择双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等方法进行皮肤软组织缺损的修复.结果 鼻部皮肤恶性小肿瘤54例,基底细胞癌39例占72.22%,鳞状细胞癌9例占16.67%,角化棘皮瘤6例占11.11%.切除后的缺损均位于鼻部下1/3,长径均未超过2.0 cm,术中修复缺损选择双叶皮瓣20例,双侧旋转皮瓣2例,鼻唇沟皮瓣32例,术后皮瓣全部成活,未见鼻部明显变形.随访5年未见复发.结论 局部双叶皮瓣、双侧旋转皮瓣、鼻唇沟皮瓣等修复鼻部下1/3长径未超过2.0 cm的皮肤恶性肿瘤切除后的皮肤软组织缺损,可以获得较满意效果.     

局部皮瓣在鼻部皮肤肿瘤切除后创面修复中的应用

【摘要】 目的 探讨局部皮瓣在鼻部皮肤肿瘤切除后创面修复中的效果。方法 2015年3月至2016年8月于新疆维吾尔自治区人民医院皮肤科纳入65例鼻部皮肤肿瘤患者,手术切除鼻部肿瘤,根据鼻缺损的部位、大小、形状以及周围皮肤情况等选择鼻唇沟皮瓣、改良菱形皮瓣、双叶皮瓣或额鼻皮瓣等修复皮肤软组织缺损。结果 65例患者中,基底细胞癌38例,色素痣20例,角化棘皮瘤5例,鳞状细胞癌2例。切除后缺损长径均未超过2.5 cm,32例用鼻唇沟皮瓣修复缺损,16例用改良菱形皮瓣,12例用双叶皮瓣,5例用额鼻皮瓣,术后皮瓣全部成活,未见鼻部明显变形,随访1年未见复发。结论 对于鼻部皮肤肿瘤切除后长径未超过2.5 cm的皮肤缺损,用鼻唇沟皮瓣、改良菱形皮瓣、双叶皮瓣、额鼻皮瓣等修复可以获得较满意的效果。     

局部皮瓣修复面部基底细胞癌30例回顾性分析

目的:分析局部皮瓣在面部基底细胞癌手术缺损创面修复中的疗效。方法:回顾性分析该院皮肤科2016年1月—2018年1月面部基底细胞癌30例患者局部皮瓣修复的临床资料。结果 :随访1年,30例患者术后皮瓣均存活,功能良好无畸形,瘢痕较小,外观满意,无肿瘤复发及转移。结论:局部皮瓣修复基底细胞癌手术缺损效果显著。     

双叶皮瓣修复鼻尖鼻翼部位基底细胞癌术后创面1例

报道1例鼻尖鼻翼部位基底细胞癌病例及应用双叶皮瓣修复扩大切除术后创面的治疗效果。患者因"鼻尖鼻翼部位起红色斑块、溃疡半年余"来诊,病理明确诊断为基底细胞癌。应用皮外手术治疗,先予扩大切除,再于邻近正常皮肤组织设计双叶皮瓣,转移修复术后缺损部位。结果皮瓣成活,切口Ⅰ期愈合,瘢痕不明显,皮瓣色泽与周围皮肤相近,鼻外形保持较好。     

耳后皮瓣修复面部皮肤软组织缺损

<正> 面部皮肤恶性肿瘤切除后局部常出现较大面积的皮肤软组织缺损,单纯局部转移皮瓣有时难以修复,游离皮瓣往往不能完全成活,局部修复较困难。我院自2002年应用耳后皮瓣修复面部较大面积皮肤软组织缺损8例,皮瓣全部成活,局部修复和美容效果满意,现报道如下。     

O-Z-O皮瓣在面部相邻皮肤缺损修复中的应用

【摘要】 目的 探讨应用O-Z-O皮瓣修复面部相邻皮肤缺损的效果。方法 回顾性分析2015—2018年于杭州市第三人民医院皮肤科采用O-Z-O皮瓣修复面部相邻皮肤缺损的60例患者。其中，色素痣50例，脂溢性角化病4例，寻常疣3例，基底细胞癌2例，鳞状细胞癌1例。男14例，女46例，年龄18 ~ 75岁。 根据皮损情况，原位切除皮损，设计最佳切口，离断“皮瓣桥”（即相邻缺损之间的正常组织），根据皮肤张力线以及皱纹线，将两皮瓣桥残端相互交错，间断缝合固定，进行创面修复。结果 60例患者应用O-Z-O皮瓣均能完全覆盖皮肤缺损，术后皮损均Ⅰ期愈合，无瘢痕增生。结论 O-Z-O皮瓣设计灵活，切口小，可以同时切除相邻皮损并进行减张缝合，临床疗效满意，是修复面部相邻皮肤组织缺损的良好选择。     

菱形皮瓣在面部肿瘤切除中的应用

目的探讨菱形皮瓣在面部肿瘤切除后的修复效果。方法 2008年10月—2013年8月应用菱形皮瓣治疗8例面部肿瘤患者。结果 8例患者皮瓣术后均Ⅰ期愈合,术后外观满意,均无不良并发症出现。结论菱形皮瓣可应用于面部肿瘤切除后皮肤缺损的修复,是一种实用、有效的临床技术。     

邻位皮瓣修复术修复面部肿瘤切除后皮肤缺损

目的总结面部肿瘤切除后邻位皮瓣修复术修复皮肤缺损的经验。方法在全身麻醉或局部麻醉下,行皮肤病变切除,根据切除肿瘤皮肤缺损大小、部位、深度,采取A-T皮瓣、旋转皮瓣、斧形皮瓣等修复创面。结果共46处皮肤缺损,通过皮瓣转移均达到理想修复效果,未出现皮瓣坏死及并发症。结论邻位皮瓣修复面部肿瘤切除后皮肤缺损,术后无组织和器官变形,瘢痕隐蔽,与周围皮肤颜色无差别。     

手术治疗面部皮肤恶性肿瘤

目的　探讨面部皮肤恶性肿瘤的手术及修复的临床经验。方法 2000年1月至2006年12月,收治面部皮肤恶性肿瘤65例,其中基底细胞上皮瘤47例,鳞状细胞癌10例,隆突性皮肤纤维肉瘤3例,恶性黑素瘤2例,棘皮瘤恶变、血管内皮肉瘤、皮脂腺癌各1例,均予扩大切除,术中作冰冻切片监测手术切缘及基底,分别采用直接缝合、邻位随意皮瓣、扩张皮瓣、游离皮片移植修复。结果 65例患者均一期修复,皮片和皮瓣100%存活,术区外形和功能满意。随访6个月至5年,基底细胞上皮瘤局部复发1例;鳞状细胞癌1例颈部淋巴结转移,1例局部复发;恶性黑素瘤1例去世,余无局部复发和转移。结论 彻底切除面部皮肤恶性肿瘤是预防术后复发的关键。适宜的修复有助于容貌恢复,其中以邻位随意皮瓣的效果较好。     

Island composite nasal flap for nasal dorsum skin defects

Background  Skin defects on the nasal dorsum remain a challenge for the plastic surgeon. There are few local nasal flap options for the repair of proximally positioned nasal skin defects.
Methods  During a 3-year period, 22 patients were treated after excision of skin cancer in the proximal two-thirds of the nose. Nine patients (41%) were female and 13 (59%) were male, with an average age of 69 years. All patients were operated on under local anesthesia. The average follow-up was 25 months.
Results  In all patients, after tumor ablation, the skin defect was closed with an island composite nasal skin flap. Pathohistologic analysis confirmed that the margins of the removed tumor were free of malignant cells. Six patients (27.3%) had squamous cell and 16 (72.7%) had basal cell carcinoma. There was no total or partial flap loss. None of the patients has suffered from recurrence of the tumor.
Conclusions  The island composite nasal flap is a reliable technique for the closure of proximal nasal skin defects. Complications in the elevation of the island composite flap were rare, and the final result was acceptable.     

局部组织瓣即刻修复面部基底细胞癌术后效果及瘢痕形成观察

目的观察158例面部基底细胞癌(BCC)手术切除后即刻进行局部组织瓣修复的临床效果及瘢痕增生情况。方法收集、整理和统计2011年1月—2015年1月就诊于我院皮肤科、整形外科门诊的158例面部BCC患者的临床资料、组织病理资料,观察患者治疗的复发率、局部组织瓣治疗后局部形态的恢复及瘢痕形成情况。结果除5例未进行手术治疗的患者外,153例手术治疗患者随访时间0.5~5年,仅有3例复发,复发率为2%;除3例患者对术后局部形态稍有不满意外,其他患者对局部组织瓣修复后形态均较满意,满意率为98%;仅有10例患者在术后3个月内出现轻度的瘢痕增生,半年后消失。结论 BCC手术切除后即刻进行局部组织瓣修复具有较好的临床效果,瘢痕形成少,美观效果好。     

A case of penile basal cell carcinoma reconstructed by scrotal myofasciocutaneous flap

Basal cell carcinoma is the most common cutaneous malignant tumor and usually arises from the facial skin and is diagnosed as the solid tumor. However, rarely it arises from genital skin and/or proceeds with ulcerative manner. We report a case of male basal cell carcinoma arising from penile base, which showed urinary disturbance. Tumor resection including total penectomy and skin resection was performed then scrotal myofasciocutaneous flap was used to cover the defect. Scrotal myofasciocutaneous flap was useful for covering the defect in the genital lesion. Moreover, this simple closure was helpful for early postoperative ambulation especially for aged male patients.     

Squamous cell carcinoma arising in transplanted skin

Squamous cell carcinoma arising in a skin graft is rare. Previous reports concern the use of skin in heterotopic locations namely the vagina and oral cavity. We report a case of squamous cell carcinoma, which arose in a skin graft used for resurfacing a scalp defect. The defect followed the excision of a basal cell carcinoma 11 years previously. The excision was incomplete and radiotherapy had been given. The possible pathological mechanisms for the development of a squamous cell carcinoma in transplanted skin are discussed.     

改良菱形皮瓣在面部基底细胞癌手术缺损修复中的应用

目的：分析改良菱形皮瓣在面部基底细胞癌手术缺损修复中的应用。方法：选取2012年2月至2016年5月在我院就诊的面部基底细胞癌患者为研究对象，采用常规肿瘤切除术及改良菱形皮瓣修复术对患者进行治疗，对患者的术后不良反应、瘢痕恢复情况等进行总结分析。结果：本研究共纳入41例患者，术后所有患者皮瓣均I期成活，创面平整，未见皮下血肿及感染，周围器官未发生明显位移或畸形；其中2例患者眼部略有牵拉变形，随访1年后变形情况逐渐改善，双眼基本对称；术后瘢痕评估结果显示，患者瘢痕颜色评分为0.61±0.08、平整度评分为0.40±0.06、弹性评分为0.72±0.15、宽度评分为0.86±0.10。结论：改良菱形皮瓣在面部基底细胞癌手术缺损的修复中有较好的疗效。     

Fine needle aspiration cytology of basal cell carcinoma of the skin: a clinical and cytopathological appraisal.

This report describes the fine needle aspiration cytologic findings of 22 cases of basal cell carcinoma of the skin. The series consisted of 17 men and 5 women with a mean age of 60.7 years (range, 35-80). All the patients were from south of Xinjiang and were outdoor workers with histories of prolonged exposure to strong sunlight. Histopathologic study was performed in all cases. Using fine needle aspiration cytology (FNAC) in evaluating basal cell carcinoma, there were no false-positive cases, but one false-negative one giving a diagnostic accuracy of 95.65%. Cytologic features suggestive of basal cell carcinoma included increased numbers of small, uniform hyperchromatic, relatively little cytoplasmic cell clusters. The peripheral cells appeared in monolayer form as a papillated outline with very strong cellular cohesion. Scattered tumor cells were seldom seen. The differential diagnosis of basal cell carcinoma in FNAC includes poorly differentiated squamous cell carcinoma, eccrine gland carcinoma, and neuroendocrine carcinoma of the skin. FNAC diagnosis of basal cell carcinoma is essential in order to ensure proper treatment.     

The cuticular purse string suture: a modified purse string suture for the partial closure of round postoperative wounds

BACKGROUND: The purse string suture can be used to provide primary closure for small skin defects or as a partial closure for larger round wounds. The size of the defect is reduced secondary to the tension placed on the suture, which uniformly advances the skin from the entire periphery of the wound. METHODS: We reviewed retrospectively the features of 98 consecutive patients for whom a total of 100 cuticular purse string sutures were used to partially close their postoperative surgical defects. The location and types of the tumors removed were also summarized. RESULTS: Postoperative wounds were created following Mohs' micrographic excision of nonmelanoma skin cancer (basal cell carcinoma, 44; squamous cell carcinoma, 25), wide local excision of melanoma (29), or conservative excision of benign cutaneous neoplasms (two). The incidence of purse string suture for partial closure of each tumor was 4.1% for basal cell carcinoma, 7.3% for squamous cell carcinoma, and 46.3% for melanoma. The tumors were equally distributed on the trunk, head and neck, and extremities; however, purse string closures for basal cell carcinomas were more frequent on the trunk, head, and neck, relative to squamous cell carcinomas and melanomas, which were more common on the extremities. Concurrent medical problems and/or the use of an agent with anticoagulant or antiplatelet effects were noted in more than 50% of patients. Absorbable material of thicker diameter was most frequently used for the suture, and the postoperative wound area decreased by 6-90% (mean, 60%) following purse string partial closure. The suture was usually removed after 3-4 weeks. Postoperative complications occurred in six patients: allergic contact dermatitis in two, wound infection in two, exuberant granulation tissue in one, and hypertrophic scar in one. All of the wounds healed completely with either a round or linear scar. CONCLUSION: The cuticular purse string suture is a rapid and simple procedure that provides complete or partial closure of round skin defects and excellent long-term cosmetic and functional results. This closure provides uniform tension to the wound, enhances hemostasis at the tissue edge, and significantly decreases the size of the defect. Partial wound closure with the purse string suture may be advantageous following the local excision of melanoma, either as definitive surgical wound management or as a temporary partial wound closure prior to subsequent complete repair of the surgical defect. The purse string suture is also useful following nonmelanoma skin cancer removal in patients who insist on maintaining an active lifestyle in the immediate postoperative period, who are receiving one or more systemic anticoagulant and/or antiplatelet agents, and who have large surgical wounds that would require either a skin graft or a local cutaneous flap in order to close the postoperative defect.