扩大的耳廓组织瓣游离移植修复鼻基底细胞癌术后缺损

目的:探讨应用扩大的耳廓复合组织瓣修复鼻部基底细胞癌扩大切除术后缺损创面的手术方法及适应证。方法:根据患者病理确诊后实施鼻部基底细胞癌扩大切除术,依据缺损范围,采用单侧或双侧扩大耳廓复合组织瓣游离移植进行修复。术中彻底切除癌组织,病理证实切缘(-),将耳廓复合组织瓣游离,楔形植入鼻部缺损区,适度加压包扎固定,术后2周拆线。结果:本组18例患者,均移植成功,外形满意。修复创面面积约2.0~2.5cm,随访患者3~6个月,移植初期创面组织高出鼻部周缘,后期均发生不同程度回缩,与周缘组织融合自然,外形基本满意。结论:通过病理学证实肿物性质,确保周缘阴性,形成扩大创面,选用扩大耳廓复合组织瓣游离移植修复,通过对移植组织块精细缝合和适度加压固定技术,使创面得以修复,外形自然,供区隐蔽。本术式是较理想修复鼻部较大创面的术式选择。

Applying composite tissue flap extending behind ear to repair the region defect because of the resection of nasal basal cell carcinoma

Objective To discuss the operation method and indication of applying composite tissue flap behind ear to repair the region defect because of the resection of nasal basal cell carcinoma extending. Methods To implement the resection of nasal basal cell carcinoma extending, after diagnosing the patient＇s pathology. According to defect range, to repair the region defect by transplanting composite tissue flap expanded unilaterally or bilaterally. In operation, the cancer tissues are resected completely and the free composite tissue flap is transplated to the region defect. The wound must pressurize the wrap properly. Taking out stitches after two weeks of operation. Results The transplantation is successful among 18 patients. About 2.0cm to 2.5cm region defect is repaired. The observation of 3-6 months shows that at the early stage of transplantation the wound tissues tower above nasal periphery,later shrink to different extent and external form is satisfactory. Conclusion According to pathology,when the goitre is sure to be feminine,the region defect can be repaired by the transplantation,suture and moderate fixation technique of free composite tissue flap behind ear.And the external form is natural. So this operation is the best choice to repair nasal region defect.