上臂内侧带蒂皮瓣在创伤后鼻缺损美容整形中的应用

目的探讨上臂内侧皮管(瓣)带蒂移植在创伤后鼻缺损美容整形中的应用。方法 2008年11月~2015年1月,笔者应用上臂内侧带蒂皮管(瓣)修复创伤后鼻缺损11例(男性9例,女性2例;年龄18~43岁),其中一期皮管(瓣)成形同时转移修复8例,其余3例采用一期上臂形成皮管(瓣)、二期带蒂转移修复鼻缺损、三期皮管断蒂完成鼻再造。结果本组11例患者鼻部转移皮瓣血运良好,鼻腔通气功能良好。随访9例,1~3个月时颜色与周围皮肤相差较大,1年后颜色相近,两侧鼻孔对称,鼻外形良好,基本达到美容修复的目的。结论上臂内侧带蒂皮管(瓣)设计相对不受限制,提供的组织量多,成活率高,在患者不接受面部遗留新瘢痕的情况下,是一种较好的选择方法。

Cosmetic repair of nasal defects with medial pedicle skin flap of the upper arm

Objective To investigate the methods to repair traumatic defects on nose with medial pedicle skin tube ( flap) of the upper arm.Methods Eleven patients with nasal defects were repaired in our department from Nov.2008 to Jan.2015.To repair their defect,all patients were treated with medial pedicle skin tube ( flap) of the upper arm.Among them skin tubes( flap) were formed,transferred and repaired simultaneously in 8 patients;for the rest 3 patients,skin tubes( flap) of upper arms were formed in the first stage,nasal defect was transferred and re-paired in the second stage,and noses were successfully reconstructed with pedicle division in the third stage.Re-sults All the 11 patients achieved good blood circulation in skin flaps and good ventilation in nasal cavity.The fol-low-up of 9 patients showed that during the first 3 months after the operation,the color of skin tube ( flap) was obvi-ously different from the surrounding skin,but gradually similar after 1 year.Besides,bilateral nostrils achieved sym-metry with good appearance.The cosmetic repair was basically achieved.Conclusion The design for medial pedi-cle skin tube ( flap) of the upper arm is not restricted comparatively,but it significantly improves the tissue survival rate by supplying sufficient tissue.It might be a better alternative for those patients who prefer not to leave new scars on their faces.