局部旋转皮瓣修复面部基底细胞癌切除术后皮肤缺损

目的:探讨面部基底细胞癌手术缺损的修复方法及效果。方法:观察16例确诊为基底细胞癌患者肿瘤切除术后局部旋转皮瓣修复缺损的疗效。结果:16例患者手术后创面愈合良好,术后外形患者满意,不影响功能。结论:应用局部旋转皮瓣修复面部基底细胞癌术后缺损,有较好的效果。     

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。     

双叶皮瓣修复面中部基底细胞癌切除后皮肤缺损19例

目的探讨面中部皮肤肿瘤手术切除后缺损修复的有效方法,分析双叶皮瓣修复皮肤缺损的设计模式。方法面中部皮肤肿瘤手术切除后,根据皮损位置和大小,在皮损外侧规范设计双叶皮瓣,充分皮下游离,转移皮瓣,分层间断缝合。结果19例患者,4例第二叶皮瓣远端皮肤术后发生0．1cm×0．2cm范嗣内的皮瓣血运障碍、坏死,后经积极换药后愈合;15例第二叶皮瓣、19例第一叶皮瓣术后全部成活。全部病例手术后眼、鼻、口外观均未见明显畸形。结论皮肤缺损外侧模式设计的双叶皮瓣,是一种能够修复面中部皮肤缺损的成形方法。     

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。     

面部基底细胞癌的手术治疗

本院1997年7月至2008年3月共收治面部基底细胞癌患者25例,分别采用直接缝合、皮片移植、局部皮瓣转移的方法修复创面.结果:25例患者切口愈合良好,术后外形满意,无1例复发.面部基底细胞癌首选手术皮瓣修复尤其是改良菱形皮瓣,可取得理想的治疗效果.     

双向推进皮瓣修复左唇皮肤基底细胞癌1例

报告1例女性患者,68岁,左上唇鼻翼前庭口处一肿物2年余,近2个月生长速度较快。皮肤科情况:表面呈不规则高起,附着红棕色痂皮,肿物周围伴有色素减退,少量出血,有黄色渗液。结合组织病理诊断:皮肤基底细胞癌。病变发生特点:肿物位于左唇上方鼻前庭下方,紧邻红唇的唇峰,占左上唇正常组织2/3。手术范围包括了整个上唇的功能部位,切除范围大。手术方法:充分利用左侧多余松弛皮肤的优势将两侧的皮瓣双向推进对侧正常拉拢缝合,既兼顾了病人的美观及咀嚼功能,又可将浸润面的瘤组织彻底清除,术后启口功能存在,红唇基本保持原形。     

风筝皮瓣修复基底细胞癌术后缺损临床观察

基底细胞癌是皮肤科常见的恶性肿瘤之一,好发于颜面、手背等身体的暴露部位,治疗以手术扩大切除为主.多数患者无疼痛或瘙痒等不适症状,往往就诊较晚,就诊时肿瘤浸润范围及深度已较广泛,手术切除后残留较大创面,难以修复.自2006年至2012年对部分基底细胞癌根治术后患者采用风筝皮瓣修复术后缺损,修复效果好,报道如下.     

局部皮瓣转移治疗头面部基底细胞上皮瘤4例

局部皮瓣转移治疗头面部基底细胞上皮瘤４例朱威，郑淑文，陈懿德首都医学院附属北京红十字朝阳医院皮肤科（邮政编码１０００２０）我科于１９９２年１０月～１９９３年１１月应用手术方法治疗４例基底细胞上皮瘤，疗效满意，报告如下。临床资料４例中男３例，女１例。年...     

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。     

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。     

107例基底细胞癌的高频超声特点

回顾性分析经病理证实的107例BCC患者的声像图(其中结节溃疡型63例、色素型22例、表浅型20例、纤维上皮瘤型1例、硬斑病型1例)。BCC的圆度系数值为1.43~17.75,平均值8.53,中位数3;22例探及血流信号,收缩期峰值流速(PSV)平均值为14.23±4.77 cm/s,阻力指数(RI)平均值为0.44±0.13。结节溃疡型、色素型和纤维上皮瘤型皮损回声形态表现为椭圆形或类圆形68例,扁平形18例,位于真皮层内62例;表浅型、硬斑病型皮损回声形态表现为椭圆形或类圆形2例,扁平形19例、位于真皮层内2例。     

皮肤基底细胞癌和皮肤鳞状细胞癌270例回顾性分析

 目的:总结我院皮肤基底细胞癌(BCC)和皮肤鳞状细胞癌(SCC)临床与组织病理资料,以期提高BCC与SCC的诊断率。方法：回顾性分析2014年1月1日-2018年12月31日间我院皮肤科门诊经组织病理切片确诊的170例BCC与100例SCC患者的临床与病理资料。结果：BCC与SCC年度发病整体均呈逐渐上升趋势。BCC、SCC男女患病比例分别为0.8∶1、1∶1，好发部位均为曝光部位(头面颈部和四肢)，临床诊断与组织病理诊断符合率分别为62.4%与30.0%。临床诊断上，BCC易与脂溢性角化病(SK)、色素痣混淆；SCC易与BCC、鲍温病、光线性角化病(AK)混淆。结论：BCC和SCC为临床常见的非黑素性皮肤肿瘤，但易误诊和漏诊。临床医生对于可疑病灶应尽早行皮损组织病理检查。     

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.     

植皮修复右颞部鳞癌切除1例

患者,男,71岁,右颞部肿物伴溃疡4个月,结合临床及组织病理诊断为低分化鳞癌,手术切除局部病灶后行植皮术,术后皮肤愈合良好,随后予以放射治疗,随访8个月,未见复发转移。     

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。     

Perceptions of facial aesthetics in surgical patients with basal cell carcinoma

BACKGROUND: Basal cell carcinoma (BCC) is a non-melanoma form of skin cancer that is frequently localized within the cervicofacial area. So far, little research is available on how patients perceive their facial aesthetics after surgical treatment for BCC. OBJECTIVES: To analyse (i) if there was a statistically significant improvement over time with regard to the perceived facial aesthetics of surgical patients; (ii) if there was a significant difference between primary and recurrent BCC patients; and (iii) between patients who had Mohs micrographic surgery (MMS) or surgical excision (SE). To assess (iv) which baseline perceptions and/or clinical parameters may predict the evaluation of facial aesthetics at 6 months after surgery. METHODS: Parallel to a clinical trial, a survey was carried out in which patients were asked, by means of a newly developed disease-specific questionnaire, about perceptions with regard to their facial aesthetics before and after surgery. RESULTS: Aesthetic perceptions of all surgical patients improved over time. There was no statistically significant difference on facial aesthetics between the group with a primary or recurrent BCC and patients treated with MMS or SE. Results also showed that the evaluation of postsurgical facial aesthetics can be predicted by both visibility of the tumour and preoperative perceptions. CONCLUSION: It is recommended to administer preoperatively a short questionnaire in which perceptions related to facial aesthetics are included. In doing so, physicians will become more familiar with the aesthetic problems patients might have regarding their afflicted facial site. Ultimately, it may help physicians in deciding whether patients will benefit from additional cosmetic procedures after surgery.     

Recurrence rate of basal cell carcinoma in patients submitted to skin flaps or grafts

BackgroundBasal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking.ObjectivesTo evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts.MethodsA retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence.ResultsOf the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types.Study limitationsRetrospective nature of the study.ConclusionThe present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.     

An overview of Mohs micrographic surgery for the treatment of basal cell carcinoma

This article reviews Mohs micrographic surgery for basal cell carcinoma. Its evolution to the present day technique, indications, and limitations are discussed, along with future expectations for the procedure.