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目的探讨改良双叶瓣修复颧面部皮肤癌切除术后缺损的疗效。方法 2009年8月-2011年10月,收治颧面部皮肤癌患者15例。男12例,女3例;年龄52~78岁,平均64.1岁。病程1~14个月,平均4.6个月。基底细胞癌11例,鳞状细胞癌4例。术前1例肿瘤病灶合并感染,余患者皮肤均无破溃;肿瘤均累及皮肤层。TNM分期:T2N0M213例,T3N0M3患者2例。肿瘤病灶切除后遗留缺损范围为4.0 cm×2.5 cm~6.5 cm×4.0 cm。采用改良的耳前、耳后双叶瓣修复缺损,切取范围第1叶皮瓣4.0 cm×2.5 cm~6.5 cm×4.0 cm,第2叶皮瓣3.0 cm×2.0 cm~5.0 cm×3.0 cm。结果术后1例切口部分裂开,经换药后痊愈;余患者皮瓣均顺利成活,切口均Ⅰ期愈合。14例获随访,随访时间12~24个月,平均18.7个月。患者面部无明显不对称,眼睑闭合无影响,无面神经损伤表现。随访期间均无肿瘤复发。末次随访时患者满意度评分:不满意1例,可以接受1例,比较满意7例,非常满意5例。结论使用改良耳前、耳后双叶瓣修复颧面部皮肤癌术后缺损可获得较好效果,且并发症少。 相似文献
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目的探讨应用耳后窄蒂皮下蒂皮瓣修复耳廓内软组织缺损的方法及疗效。方法 2008年6月-2011年7月,收治11例耳廓内肿物切除后软组织缺损患者。男7例,女4例;年龄26~75岁,平均50岁。其中色素痣5例,基底细胞癌2例,混合性血管瘤2例,皮肤乳头状瘤2例。病程3~50年,平均35年。彻底切除肿物后,软组织缺损范围为1.5 cm×1.0 cm~3.5 cm×3.0 cm。沿颞浅动脉及耳后动脉走向,设计耳后"乒乓球拍状"窄蒂皮下蒂皮瓣,通过隧道移位修复缺损,皮瓣切取范围1.8 cm×1.3 cm~3.8 cm×3.3 cm,蒂宽0.4~0.7 cm、长2~5 cm。供区直接拉拢缝合或局部皮瓣移位修复。结果术后供、受区皮瓣均顺利成活,切口均Ⅰ期愈合。术后8例获随访,随访时间6个月~1年。皮瓣质地、弹性、色泽良好,耳廓外形良好。肿瘤患者无复发。结论耳后窄蒂皮下蒂皮瓣蒂部窄长、旋转角度大、修复范围广、不含知名血管,手术操作简便,供区隐蔽,是修复耳廓内软组织缺损的理想方法之一。 相似文献
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目的:面部术后缺损修复需要充分重视患者的美学诉求,是一项极具挑战的临床工作。本文介绍一种以筋膜脂肪层组织作为旋转蒂的螺旋桨皮瓣及其在面部缺损修复中的运用。方法:2017年4月-2019年12月,笔者科室使用此皮瓣对18例面部良恶性肿物切除患者进行修复,缺损面积1.4cm×1.8?cm~4.2cm×4.9?cm。术后,观察患者疗效及复发情况。结果:本组18例患者,术后皮瓣全部存活,切口均为一期愈合。术后随访半年至1年,病灶均无复发,术区平整,无猫耳现象,切口瘢痕不明显,面部器官无牵拉。患者均表示对手术效果较为满意。结论:筋膜脂肪蒂螺旋桨皮瓣经合理的术前设计可广泛运用于颜面部术后创面修复,且效果确切,值得临床推广。 相似文献
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颈部预构扩张皮瓣修复面部缺损 总被引:1,自引:0,他引:1
目的:报道应用颞浅血管束预构颈部扩张皮瓣修复面部缺损的手术效果,推广该术式在临床上的使用。方法:自1998年5月至2006年9月,对18例面部大面积瘢痕、血管瘤、黑痣的病人采用颞浅血管束预构颈部扩张皮瓣转移修复。结果:18例中有1例出现皮瓣远端小范围坏死,经换药后愈合,1例术后随访发现皮瓣挛缩下睑外翻,经手术矫治痊愈,其余16例皮瓣完全成活,皮瓣色泽、质地与面部皮肤相似,外观良好。结论:应用颞浅血管束转移预构颈部扩张皮瓣修复面部缺损方案可行,效果良好,是修复大面积面部皮肤缺损的理想方法。 相似文献
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目的:探讨颞浅动脉跨区供血的反流轴型耳后岛状皮瓣在修复面部缺损中的应用。方法:根据颞浅动脉的解剖分布及其与耳后动脉的吻合特点,制备以颞浅动脉供血的耳后岛状皮瓣,经皮下隧道转移至受区,修复面部缺损。结果:本组19例患者,17例全部存活,皮瓣的形态、色泽及功能良好。2例早期出现静脉回流障碍,积极处理后,皮瓣远端仅有小部分表皮坏死。结论:颞浅动脉跨区供血的反流轴型耳后岛状皮瓣修复面部缺损,是比较理想的修复方式。 相似文献
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局部皮瓣在颜面外伤软组织缺失修复中的应用 总被引:1,自引:6,他引:1
目的 探讨应用局部皮瓣修复面部外伤软组织缺失的美学效果.方法 自2005年7月至2007年12月,收治因各种外伤导致的颜面局部皮肤软组织缺失患者27例,采用鼻唇沟皮瓣、改良的菱形皮瓣、皮下蒂皮瓣、滑行推进皮瓣、A-T皮瓣等多种皮瓣进行修复.结果 27例面部软组织缺失患者,伤口均Ⅰ期愈合,所有皮瓣全部成活,经6~18个月随访,伤口瘢痕不明显,功能满意,美学效果良好.结论 面部外伤导致的皮肤软组织缺失,情况复杂多变,根据软组织缺损的部位、范围、形状,选择适当的局部皮瓣进行修复,能达到理想的美学修复效果. 相似文献
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Skin grafted forehead flap for total nasal reconstruction in severe postburn facial deformity 总被引:1,自引:0,他引:1
Summary Total or subtotal nasal loss is one of the sequelae of severe facial burns and requires total nasal reconstruction. Distant flaps or tube pedicles were used but the result was not good in terms of skin color match and texture. Since 1982 the authors have used a skin grafted forehead flap for nasal reconstruction and have achieved a better color match for the new nose. This forehead flap is quite rigid and a bone graft is not needed for support. However, the flap is not as easily brought down to the nasal area as the standard forehead flap; thus, in the last five cases the supraorbital and the supratrochlear arteries on both sides had to be sacrificed. There was no compromise of the blood supply to the flap and the mechanism by which the flap retains its good blood supply remains to be elucidated. 相似文献
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目的:评价应用菱形皮瓣修复皮肤软组织缺损的效果。方法:2005年1月~2010年12月,我们应用菱形皮瓣修复色素痣、瘢痕、体表肿瘤等切除后缺损患者46例,术中将病变组织行圆形或椭圆形切除,于缺损邻近处设计菱形皮瓣,将菱形皮瓣转移修复缺损,供区直接缝合。结果:皮瓣全部成活,切口Ⅰ期愈合,形态满意。结论:菱形皮瓣是修复皮肤软组织缺损理想的选择,其效果满意,方法简便。 相似文献
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Carlos Pinho Miguel Choupina Pedro Silva Pedro Ferreira Isabel Guimar?es José Amarante 《British journal of plastic surgery》2003,56(6):599-602
A retroauricular reverse flow flap based on the anastomosis of the frontal branch of the temporal superficial artery with the corresponding vessel of the opposite side as well as with the ipsilateral supraorbital and supratrochlear arteries, was used in two clinical cases for forehead and facial reconstructions. The arc of rotation associated with the length of the pedicle allows its transfer, in a one-stage procedure, to cover small to medium defects of any part of the forehead, face and parts of the scalp. The procedure is safe, simple and causes minimum donor site morbidity. 相似文献
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目的 介绍一种打破常规任意皮瓣长宽比例限制的狭长窄蒂皮瓣在面额部皮肤癌切除后组织缺损修复中的应用,并探讨其成活机制.方法 设计不带知名血管,以耳前或耳后狭长皮肤筋膜或单纯筋膜为蒂的侧颌颈部皮瓣,修复面额部皮肤癌切除后组织缺损26例,其中颞额区皮肤基底细胞癌5例,皮肤鳞状细胞癌6例,面部恶性黑色素瘤1例,基底细胞癌8例,鳞状细胞癌5例,皮肤黏液癌1例.26例皮瓣的蒂部有24例在耳前,2例在耳后;4例仅为筋膜蒂.皮瓣最大10.0 cm×8.0 cm,最小3.0 cm×2.5cm,蒂宽1.0~1.5 cm,蒂长2~6 cm.结果 26例狭长窄蒂皮瓣除5例皮瓣远端淤血,其后渐恢复,其余全部成活,修复后局部外形理想.结论 该狭长窄蒂皮瓣不带知名血管,其长宽比例超过常规任意皮瓣,无需解剖血管,切取容易,蒂部狭长使其旋转和覆盖范围大,供、受区邻近,是修复面额部皮肤癌扩大切除后组织缺损的理想皮瓣. 相似文献
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The tagliacotian cross-arm flap finds its basis in one of the oldest reconstructive techniques known, the brachial flap of Gaspar Tagliacozzi. Although not commonly employed today, it remains useful in difficult orbital and nasal reconstructions. Our report deals with the historic development, applicability, timing, and technique of this procedure and is well illustrated by a case report. Advantages of the tagliacotian flap include no additional scarring in the exposed area and a hidden donor site. A considerable amount of usually non-hair-bearing tissue can be transferred without sacrifice of valuable muscle and without special surgical techniques. The tagliacotian cross-arm flap should be considered when local and regional tissue supply is inadequate, when aesthetic desires of the patient preclude additional local scarring, and when time allows for the training and transfer of this flap. 相似文献
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目的 探讨阅读者皮瓣与菱形皮瓣修复皮肤缺损创面的临床疗效.方法 自2018年4月至2019年4月徐州市中心医院整形美容科对皮肤肿物切除后的皮肤软组织缺损患者采用阅读者皮瓣修复6例、菱形皮瓣修复10例,并对其治疗效果及术后并发症等进行回顾性分析;术后3个月随访,对患者的皮瓣色泽、质地及瘢痕等情况通过视觉模拟评分法(vis... 相似文献
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H Saito Y Kimura G Tsuda S Fujieda T Ohtsubo T Saito M Yoshimura 《Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi》1999,33(1):41-45
The thicknesses of three dermal flaps, platysma, forearm, and fibula, which are often used for oropharyngeal reconstruction, were measured in 21 subjects using 15 MHz Doppler ultrasonography. The mean (SD) thicknesses were 2.2 (0.3), 3.1 (0.5), and 3.8 (0.6) mm, respectively. The free peroneal skin flap from the leg was used in 14 patients with head and neck cancer. These flaps were successfully transplanted in 13 of 14 patients (93%) with no problems at the donor site. This flap offers many advantages, including its distance from the head and neck, its cosmetic superiority to a forearm flap, it allows two flaps with two cutaneous branches, it is possible to close the donor site primarily without a skin graft, and it has thin subcutaneous tissue. We found that the free peroneal skin flap is particularly useful for oropharyngeal reconstruction. 相似文献