风筝皮瓣在修复鼻尖部皮肤软组织缺损中的应用

目的：介绍应用＂风筝＂皮瓣修复鼻尖部较大皮肤软组织缺损的经验和体会.方法：切除病变组织后,采用皮损上方的皮下筋膜蒂皮瓣修复创面10例.结果：所有病例皮瓣全部成活,皮瓣颜色与质地同周围组织一致.结论：＂风筝＂皮瓣修复鼻尖部较大皮肤软组织缺损,手术简单,组织创伤小,效果佳.     

应用三叶皮瓣修复基底细胞癌术后鼻尖鼻翼巨大缺损

鼻位于面部中央,立体感强,对面部美学有重要的影响,同时也是皮肤肿瘤的好发部位。在手术切除肿瘤的同时需要使用合适的方法修复手术缺损区域,达到不影响鼻外观和功能的效果。由于鼻部结构较复杂,皮肤及皮下组织连接紧密,皮肤移动度较小,因此鼻部肿瘤切除后缺损修复比较困难,尤其是鼻尖鼻翼的巨大缺损既往没有较好的修复方式。     

随意微小皮瓣在颜面部皮肤缺损Ⅰ期修复中的应用

目的 观察随意微小皮瓣修复颜面部皮肤外科手术后皮肤缺损的效果.方法 203例颜面部皮肤外科手术患者,在切除皮损后,根据术中缺损情况设计随意微小皮瓣Ⅰ期修复皮肤缺损.结果 完成了8种205处皮瓣Ⅰ期修复颜面部皮肤缺损.其中182例术后效果佳,面部无牵拉变形,不是你、瘢痕隐蔽21例患者术后皮瓣远端表皮坏死.形成皮瓣的部位最常见于颊部.其次是眼睑、额部、颞部、耳前、颏部、应用最多的是滑行推进皮瓣,其次是旋转皮瓣.结论 合理设计个性化随意微小皮瓣Ⅰ期修复颜面部小面积皮肤缺损.可获满意疗效和美容效果.     

应用局部皮瓣修复内眦皮肤缺损15例

目的 报道局部皮瓣修复皮肤肿瘤切除后的缺损的经验与体会.方法 使用局部皮瓣修复内眦部皮肤缺损15例,创面面积约1 cm×1 cm～1.8 cm × 2.0 cm.根据创面的位置及大小,分别选择眉间皮瓣、旋转皮瓣、推进皮瓣、鼻唇沟皮瓣或联合使用两种局部皮瓣等方法进行修复.结果 15例中12例使用单一皮瓣修复创面,3例使用两个局部皮瓣联合修复创面,共使用18个局部皮瓣,术后皮瓣全部成活,切口Ⅰ期愈合.术后随访11例6个月至1年,皮瓣与周围皮肤组织的色泽、质地相近,切口瘢痕隐蔽,未发生内眦部及附近组织器官明显畸形,形态满意,功能良好.结论 修复内眦部皮肤缺损时,如果能选取合适的局部皮瓣,并注意保持和恢复内眦美容单位的完整性,将取得良好的形态与功能效果.

Abstract：

Objective To reconstruct skin defects with local flaps after resection of tumors. Methods From October 2006 to December 2009, medial canthal defects in 15 patients were repaired with local flaps in the hospital. The size of the defects varied from 1 cm × 1 cm to 1.8 cm × 2.0 cm. According to the size and location of the defects, different local flaps such as glabellar flaps ,rotation flaps, advancement flaps, nasolabial flaps and combination of these local flaps were selected and designed to repair the skin defects. Results Of the 15 patients, 12 received the reconstruction of skin defects with single flap, the other 3 with two flaps; totally,18 local flaps were designed and applied. All the flaps survived with primary healing postoperatively. A followup in 11 patients for 6 to 12 months showed that the color and texture of flaps were similar to those of surrounding tissues and incision line scar was inconspicuous. Medial canthal contours were restored without distortion of surrounding structures. Satisfactory function and aesthetic outcomes were achieved. Conclusions In the repair of inner canthus skin defects, to maintain and restore the "cosmetic unit" integrity of inner canthus by using suitable local flaps would lead to a satisfying restoration of function and appearance.     

O-Z皮瓣在腰骶部皮肤缺损修复中的应用

目的:探讨应用O-Z皮瓣修复腰骶部皮肤缺损的临床疗效。方法:于局麻下进行手术,距腰骶部皮损边缘0.5~2.0cm完整切除皮损后,在缺损区周边正常皮肤设计O-Z皮瓣,修复创面。结果:12例患者中,缺损面积最大10.2 cm×6.5 cm,最小3 cm×2.7 cm,术后伤口均Ⅰ期愈合,皮瓣全部成活,术后随访3~12个月,无感觉异常,皮损无复发。结论:应用O-Z皮瓣修复腰骶部皮肤肿瘤扩大切除后所形成的缺损,皮瓣张力小,血运丰富,易于成活,耐摩擦,且皮瓣区与周围皮肤颜色一致,瘢痕不明显,是腰骶部较大皮肤缺损修复的一种优选方法,适合临床推广应用。     

A-T皮瓣修复颞部皮肤肿瘤切除后缺损32例

目的 介绍应用A-T皮瓣修复颞部皮肤肿瘤切除术后创面缺损的经验和体会。方法 在遵循皮肤肿瘤切除原则基础上彻底切除皮肤肿瘤,设计A-T皮瓣修复颞部皮肤缺损,A形两侧切口线顺应眼部鱼尾纹走向,T形底边为顺应或平行发际线和耳前轮廓线的曲线,形成上下两个推进皮瓣修复中间三角形缺损,术后的切口线隐蔽。结果 本组共32例患者,颞部皮肤缺损面积最大2.8cm×4.0cm,术后皮瓣全部成活,外形美观。随访2年,未见复发,效果满意。结论 应用A-T皮瓣修复颞部皮肤肿瘤切除术后创面缺损,术后可获得满意的美容修复效果。     

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。     

改良菱形皮瓣修复颧颊部皮肤缺损

目的:评价改良菱形皮瓣修复颧部及颊部皮肤病变切除后缺损的效果.方法:患者皮肤病变切除后,于颧部或颊部邻近部位设计并切取改良菱形皮瓣,予以旋转推进修复.结果:自2017年2月至2019年12月,应用改良菱形皮瓣修复颧颊部皮肤缺损15例,男9例、女6例,年龄6～80岁.病变包括色素痣6例,疣状增生物4例,脂溢性角化病3例,...     

应用局部皮瓣修复内眦皮肤小面积缺损11例

目的: 评价应用局部皮瓣修复内眦缺损的效果。方法: 使用局部皮瓣修复内眦部皮肤缺损11例,创面面积约l .2cm×1.2cm～1.8 cm×2..5cm。根据创面的位置及大小,分别选择眉间皮瓣、菱形皮瓣、风筝皮瓣或联合使用两种局部皮瓣等方法进行修复。结果: 11例患者皮瓣均成活,术后随访10个月至3年,其外观形态良好,效果满意,肿瘤无复发。结论：修复内眦部皮肤缺损时,如果能选取合适的局部皮瓣,并注意保持和恢复内眦美容单位的完整性,可取得良好的形态与功能效果。     

鼻尖部皮肤混合瘤2例

例1女,40岁,鼻尖部无痛性肿物2年;例2女,36岁,鼻尖下方无痛性肿物3年。2例均表现为鼻尖部皮下结节,淡红色,表面光滑,边界清楚,中等硬度,无压痛。皮肤组织病理检查均支持"皮肤混合瘤"的诊断。     

Advancement flap for the reconstruction of nasal ala and lateral nasal tip defects

Repair of nasal ala and lateral nasal tip defects provide unique reconstructive challenges. This article describes a one-staged advancement flap for repair of such defects. The flap may be medially-based, laterally-based, or bilaterally-based. Sharp undermining is recommended, and a standing cone must be removed superior to the defect, perpendicular to the alar rim. Temporary alar rim flattening is accepted, and normalizes with time. This reconstruction has provided excellent functional and cosmetic results for defects measuring <1 cm in diameter on the nasal ala and lateral nasal tip.     

Transposition island pedicle flaps in the reconstruction of nasal and perinasal defects

Nasal and perinasal defects provide the dermatologic surgeon a challenge. It is necessary that the dermatologic surgeon assess each defect and patient individually for optimal repair. Many reconstructive options exist. This report demonstrates the technique of the transposition island pedicle flap which may be useful for reconstruction of post-Mohs surgery defects on or near the nose.     

Rotation flap reconstruction for nasal tip defect after mohs surgery

BACKGROUND: Skin cancer of the nasal tip is frequent, and reconstruction after Mohs surgery might be challenging. The rotation flap is a very commonly used flap for reconstructions on the vertex and the extremities but rarely on the nose. In textbooks rotation flaps in nose reconstruction are rarely mentioned. OBJECTIVE: We present a rotation flap from the caudal tip and the columella of the nose for defects of the lateral tip of the nose. METHODS: With graphics and photographs of case studies we explain the mechanism of placement and movement of the flap. RESULTS: The rotation flap is useful for reconstructions of medium-size defects of the distal lateral nose tip. CONCLUSION: The rotation flap can be used in the reconstruction of laterally placed nasal tip defects. As this flap is not mentioned in textbooks for nasal tip reconstruction, its value for this localization is probably underestimated.     

Versatility of advancement flaps for nasal reconstruction following Mohs` micrographic surgery

Advancement flaps are important reconstructive options after skin cancer removal on the nose. Donor areas vary according to defect location and size. The objective of this article is to illustrate the versatility of advancement flaps in nasal reconstruction. Five patients were selected. All cases were treated with Mohs’ micrographic surgery prior to reconstruction to ensure that 100% of the surgical margins were free of cancer. Advancement flaps can be used to repair a wide variety of surgical defects on the nose with good matching of skin color, texture, and thickness. With careful planning, resulting scars can be camouflaged in natural boundary lines, leading to good functional and cosmetic outcomes.     

Utility of the quadrilobe flap for repairing defects of the nasal tip

The quadrilobe flap allows the mobilisation of the skin of the upper nose and nasofacial sulcus to the distal nose while avoiding unfavourable tension vectors that would distort the free margin of the ala. We report our experience over the past 3 years in the first case series of quadrilobe flaps for repair of surgical defects on the nose.     

Repair of nasal tip and alar defects using cheek-based 2-stage flaps: an alternative to the median forehead flap

OBJECTIVE: To describe our use of cheek-based 2-stage transposition flaps for repairing Mohs surgery defects of the lower third of the nose. DESIGN: Retrospective case series. SETTING: Private dermatologic day surgery facility.Patients Twenty-eight patients with defects of the lower third of the nose after Mohs surgery.Intervention Ten alar and 18 nasal tip defects repaired using cheek-based 2-stage transposition flaps. MAIN OUTCOME MEASURES: Acceptability of procedure to patient, complications, and appearance from photographic records. RESULTS: The procedures were well tolerated and achieved good cosmetic results without major complications. CONCLUSIONS: These flaps allow repair of extensive defects of the nasal tip and ala with the patient under local anesthesia. This approach provides an alternative to the median forehead flap for nasal tip repairs.     

Paramedian forehead flap for the reconstruction of extensive nasal defects

BackgroundThe Department of Dermatology at Hospital Universitario de Guadalajara in Spain is a referral center for Mohs micrographic surgery. Consequently, we are regularly faced with the problem of repairing large surgical defects on the nose. The paramedian forehead flap is currently one of the techniques of choice for the repair of such defects.Materials and methodsWe review our experience in the repair of nasal defects using the paramedian forehead flap over the period from 2004 to 2008. We describe the surgical technique, complications, and final results.ResultsTen patients (mean age, 75.1 years) were treated using this flap. Two patients also required cartilage grafts and reconstruction of the internal nasal lining. The most common complications were bleeding (60%) and partial necrosis (10%). The final cosmetic and functional results were considered good or excellent in 90% of cases.ConclusionsThe forehead flap continues to be one of the best options for the closure of surgical defects of the nasal pyramid larger than 2 cm. Adequate knowledge and careful application of the technique allows excellent results to be obtained with few complications.