颞浅血管顺行与逆行岛状皮瓣的临床应用

目的 探讨各种颢浅血管顺行与逆行岛状轴型皮瓣在眶区皮肤组织缺损修复中的应用。方法 根据颢浅血管的解剖分布及其与眶上血管、滑车上血管、耳后血管等的吻合情况，制备额部、头皮、耳前及耳后等各种岛状皮瓣，通过皮下隧道移转至受区，修复各种原因所致的眶区皮肤组织缺损。结果 本组共22例，顺行岛状轴型皮瓣13例，逆行岛状轴型皮瓣9例。其中，1例逆行耳后岛状皮瓣术后早期出现静脉回流障碍，经积极处理，皮瓣远端仅有小片表皮坏死。术后因皮瓣臃肿行二次修复者6例，余形态及功能良好。结论 根据颢浅血管分布情况及其与眶上血管、滑车上血管、耳后血管等有丰富的吻合支的解剖特点，可制备各种顺行或逆行岛状轴型皮瓣用于眶区组织缺损修复。

The application of forward and reversal flow axial island flap based on the superficial temporal artery in the orbital skin defects

Objective To investigate the application of forward and reversal flow axial island flap in the orbital skin defects. Methods According to the distribution of superficial temporal artery as well as the anastomoses with the branches of supraobital artery and supratrochlear artery,etc,the frontal,scalp,preauricular and postauricular island flaps were designed.The flaps were displaced through subcutaneous tunnel to cover all kinds of orbital skin defects. Results 13 cases of forward flow flap and 9 of reveral flow flap out of 22 cases in all were observed.One postauricular reversal flow axial island flap showed the obstruction of venous refluence in early postoperative stage,however,after active treatment,mere the distal epidermal necrosis was revealed.There were six re |operations on the postoperative flap hypertrophy.The others were in good shape and functional state. Conclusions The superficial temporal artery is one of most vital blood supply in the upper face.It has wide anastomoses with the supraobital artery and supratrochlear artery.As the colors and the nature of the frontal,preauricular and post auricular skin are close to orbital skin,the application of forward and reversal flow axial island flap based on teh superficial temporal artery can be used in the reconstruction of all kinds of orbital skin defects. ;