改良Dufoumental菱形皮瓣结合美学原理修复面部皮肤缺损

目的:研究改良Dufoumental菱形皮瓣修复面部皮肤软组织缺损的临床效果。方法:应用改良Dufoumental菱形皮瓣修复面部皮肤缺损,63例患者均为面部肿物切除后圆形或类圆形组织缺损,修复术前皮肤缺损面积为(2.68±1.81)cm~2,在缺损周围设计改良Dufoumental菱形皮瓣,转移并缝合固定。结果:皮瓣均全部成活,切口一期愈合,术后随访1个月～3年,创面无明显瘢痕,效果满意。结论:改良Dufoumental菱形皮瓣修复面部缺损效果满意、可靠。     

应用改良A-T皮瓣修复颜面部皮肤缺损

目的:评价应用改良A-T皮瓣修复颜面皮肤软组织缺损的效果。方法:2010年1月-2015年12月,笔者应用改良A-T皮瓣修复颜面色素痣、瘢痕、体表肿瘤等切除后缺损患者48例,术中将病变组织行五边形切除,于缺损邻近处设计改良A-T皮瓣,将A-T皮瓣推进修复缺损。结果:皮瓣全部成活,切口一期愈合,形态满意。结论:改良A-T皮瓣是修复颜面皮肤软组织缺损的较佳选择,其操作简便。     

局部皮瓣在头面部皮肤肿瘤切除后皮肤缺损中的应用

目的 探讨应用局部皮瓣修复头面部皮肤肿瘤切除后皮肤缺损的临床疗效.方法 对128例头面部皮肤肿瘤患者根据其性质切除肿瘤后,按皮肤软组织的缺损面积,分别设计斧头状皮瓣、改良菱形皮瓣、鼻唇沟皮瓣、A-T皮瓣、风筝皮瓣等转移至缺损区修复.结果 128例患者分别采用相应的局部皮瓣转移修复至缺损区,术后皮瓣均全部成活,供、受区切口均Ⅰ期愈合,随访3～27个月,瘢痕不明显,效果满意.结论 局部皮瓣是临床上修复头面部皮肤肿瘤切除后皮肤缺损的实用而有效的方法,且美容效果及功能恢复良好.     

局部随意皮瓣修复颜面部皮肤软组织缺损的应用

目的 探讨采用局部随意皮瓣修复颜面部各种病变切除后及外伤致皮肤软组织缺损的临床效果.方法 2008年7月-2013年6月,应用局部随意皮瓣修复颜面各部位皮肤软组织缺损56例,根据缺损的部位、形状及大小,设计不同的局部随意皮瓣,转移修复颜面部皮肤软组织缺损创面.结果 术后皮瓣全部存活良好,所有创面均Ⅰ期修复,随访3～6个月,切口愈合良好,色素沉着及瘢痕增生不明显,外形效果满意.结论 应用局部随意皮瓣修复颜面部皮肤软组织缺损可获得得满意的外观和功能效果,值得临床推广.     

菱形皮瓣在鼻部皮肤肿物切除后缺损修复中的应用

目的:探讨菱形皮瓣在鼻部皮肤肿物切除术后缺损修复中的应用。方法:2016年10月-2019年4月就诊的鼻部皮肤肿物患者采用菱形皮瓣修复切除后缺损13例。回顾各病例病灶位置及大小,切除后缺损面积、皮瓣设计方法、切口瘢痕、术后形态等,并进行统计分析。结果:13例患者鼻部病灶均得到彻底切除且未见复发,皮瓣术后外观满意,瘢痕不明显。结论:菱形皮瓣为鼻部皮肤肿物切除后缺损修复的良好方法,依据病灶的大小和位置,采用不同的皮瓣设计方式。     

阅读者皮瓣与菱形皮瓣在面部皮肤肿物切除后皮肤缺损重建中的临床应用

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...     

应用局部皮瓣修复面部软组织缺损

目的：探讨应用面部局部皮瓣修复面部软组织缺损的效果。方法：自2005年7月～2009年6月,应用局部皮瓣修复面部各部位的皮肤软组织缺损22例。根据各部位的情况设计局部皮瓣,转移修复面部皮肤软组织缺损创面。结果：术后随访22例患者3个月～5年,皮瓣完全成活,切口愈合良好,瘢痕不明显,修复的外形效果满意。结论：局部皮瓣修复面部软组织缺损创面是临床实用有效的方法,美容效果良好。     

菱形皮瓣张力最小化原则的临床应用

目的评价菱形皮瓣张力最小化原则的临床应用特点及修复不同部位皮肤缺损的术后效果。方法自1999年9月至2005年6月,应用菱形皮瓣修复面、躯干及四肢部的皮肤缺损患者17例。根据各部位的不同情况,应用张力最小化原则设计菱形皮瓣,转移修复皮肤缺损。结果术后随访17例患者1个月至3年,皮瓣全部成活,切口愈合良好,瘢痕增生不明显,修复的外形满意。结论菱形皮瓣张力最小化原则的修复方法是优化的手术方法,值得临床推广应用。     

菱形皮瓣张力最小化原则的临床应用

目的评价菱形皮瓣张力最小化原则的临床应用特点及修复不同部位皮肤缺损的术后效果。方法自1999年9月至2005年6月，应用菱形皮瓣修复面、躯干及四肢部的皮肤缺损患者17例。根据各部位的不同情况，应用张力最小化原则设计菱形皮瓣，转移修复皮肤缺损。结果术后随访17例患者1个月至3年，皮瓣全部成活，切口愈合良好，瘢痕增生不明显，修复的外形满意。结论菱形皮瓣张力最小化原则的修复方法是优化的手术方法。值得临床推广应用。     

局部皮瓣在唇颊部软组织缺损中的应用

目的 探讨应用局部皮瓣修复唇、颊部软组织缺损的临床疗效.方法 根据唇、颊部软组织缺损的范围,设计相应的局部皮瓣转移修复缺损.自2008年11月至2010年10月,对36例唇、颊部皮肤软组织病变切除后造成的缺损患者进行修复.结果 术后随访患者3～6个月,皮瓣完全成活,供、受区切口均愈合良好,瘢痕不明显,修复效果满意.结论 局部皮瓣修复唇、颊部软组织缺损是临床上实用有效的方法,且美容效果良好.     

改良菱形皮瓣修复发际部头皮缺损

目的 评价应用改良菱形皮瓣修复发际部位头皮缺损的效果.方法 自2000年1月以来,我们应用改良菱形皮瓣修复发际部位头皮缺损15例.结果 术后15例皮瓣均完全成活,切口Ⅰ期愈合,转移后的皮瓣毛发的毛流、毛向与周围毛发基本一致,效果满意.结论 改良菱形皮瓣可应用于修复发际部位头皮缺损,适用于发际部位面积不大但又不能直接缝合的创面修复.     

改良菱形皮瓣修复皮肤缺损

目的:总结改良菱形皮瓣修复皮肤缺损的的应用经验。方法:2006年～2011年,我科应用改良菱形皮瓣修复皮肤缺损共46例,创面最大7.0cm×4.5cm,最小1.2cm×0.6cm。在缺损边缘的一侧设计皮瓣,浅筋膜层内形成皮瓣,无张力下向受区转移修复创面。结果:术后除2例皮瓣尖端散在的表皮坏死外,其余存活良好,创面得以Ⅰ期修复,经1个月～5年随访,切口痕迹不明显,局部外形满意。结论:改良菱形皮瓣制作简单,是修复皮肤缺损的一种良好方法。     

扩张皮肤软组织修复缺损中菱形皮瓣的应用

目的 探讨菱形皮瓣设计对扩张皮瓣中问松弛部分的充分利用.方法扩张后的皮肤软组织在设计旋转皮瓣修复缺损时,如果中间松弛部分不能充分利用.在旋转皮瓣上再次设计菱形皮瓣来充分利用扩张后的皮肤软组织,菱形皮瓣的尖部设计在扩张最充分部分,皮瓣蒂部设计在旋转皮瓣的切口侧,要注意保证菱形皮瓣与旋转皮瓣形成的复合皮瓣的长度与蒂的宽度比例在2.5:1.0.结果 11例在旋转皮瓣上再次设计菱形皮瓣,复合皮瓣的长宽比例最大达到3:1,多数在2.5:1.0.皮瓣全部存活,有1例皮瓣尖部小面积血运障碍,1例菱形皮瓣尖部早先轻度淤血.结论 该设计较充分、合理的利用了扩张后的皮肤软组织,最大可能的修复了缺损.复合皮瓣设计,一是注意长宽比例,二是尽量选择蒂部有知名血管的轴型皮瓣以策安全.只要设计合理,该方法是安全的,值得推广.     

Direct closure of radial forearm free-flap donor sites by double-opposing rhomboid transposition flaps: case report

A basic disadvantage of the radial forearm flap is the removal of skin from a functionally important and cosmetically exposed region. The donor site is conventionally repaired by skin grafting. However, this method is associated with complications of graft take and a poor aesthetic appearance. In this report, the authors describe a simple technique for direct closure of a distal forearm flap donor defect, using double-opposing rhomboid transposition flaps. This method is based on the existence of an oblique skin laxity in the distal forearm from the ulnar to the radial side, allowing a double-opposing local flap design. In a 32-year-old female patient, a 6- X 4-cm longitudinally-oriented elliptical skin defect of a radial forearm free flap was succesfully closed directly with the described technique without any complications. This method is a useful alternative for primary closure of small- to medium-sized distal forearm defects.     

The nasolabial rhomboid flap.

Nasolabial flaps are frequently used for reconstruction of nasal and midfacial defects. The donor site and the quality of the skin provided are excellent, though reconstructive results are sometimes hampered by a dog-ear at the base of the flap. Properly designed rhomboid flaps generally rotate into position without a dog-ear. By combining the nasolabial donor site with the rhomboid design, the advantages of both methods of reconstruction can be combined. Nasolabial rhomboid flaps have been used successfully in seven patients. Reconstructions in all instances have been of high quality, and no revisions have been required after at least 6 months of follow-up. The nasolabial rhomboid flap is a refinement of existing techniques that can maximize the aesthetic quality of midfacial reconstructions.     

Rhomboid perforator flap for a large skin defect due to lumbosacral meningocele: a simple and reliable modification

To date, very few studies have reported the use of perforator flaps in newborn infants with an immature vascular system. Therefore, it is not clear whether perforator flaps can be used in newborns, as in adults. In this study, we applied the perforator flap procedure to a newborn infant, who had a large skin defect due to lumbosacral meningocele. We used the rhomboid perforator flap, which was a combination of using a rhomboid flap reported by Ohtsuka et al and preserving paraspinal perforator vessels according to Thomas. Although perforator vessels were so thin as to necessitate careful dissection and flap design, a good result was obtained by this procedure. We consider that the rhomboid perforator flap is a simple and reliable procedure for the treatment of lumbosacral meningocele.     

The use of subcutaneous pedicle multiple rhomboid flaps in the treatment of long postburn scar contractures

The subcutaneous pedicle rhomboid flap is a relatively new technique in the treatment of linear, wide or quadratic postburn scar contractures with two or more contracture lines. The effectiveness of the rhomboid flap depends on lengthening the contracture band by relaxation incisions and closing the emerged defect by suturing the rhomboid flap in V-Y and Y-V advancement. The technique is simple, efficient and versatile. The broad subcutaneous pedicle of the flap is very reliable and postoperative flap necrosis is rare. Clinical results show that the gain in length provided by a single rhomboid flap ranges from 75-90%. However, the technique may not be efficient enough to release the whole band in cases of long contracture bands. Therefore, a new design of rhomboid flaps, called "multiple rhomboid flaps", may be needed. Twelve patients (aged 3-40 years) with long linear and wide scar contractures were successfully treated with subcutaneous pedicle multiple rhomboid flaps. Multiple consequent or adjacent rhomboid flaps were applied in the upper extremity (in nine patients), trunk (in seven patients), and lower extremity (in two patients). Complete relaxation and elongation of the contracture bands were achieved in all of the cases and all rhomboid flaps healed uneventfully. The results were functionally and cosmetically successful. The application of rhomboid flaps in this consequent and adjacent fashion is a new concept. Clinical results prove that the technique is versatile and effective in the release of long potstburn scar contractures. Since distortion of the surrounding skin or displacement of anatomical landmarks is not seen with the technique, color and texture matches are perfect. Designing and performing multiple rhomboid flaps is very simple and the operation time is short. As no undermining is carried out in the technique, the flaps are more reliable than commonly used multiple Z-plasty.     

颜面部皮肤软组织缺损的整形外科治疗

目的:探讨应用整形外科技术治疗颜面部皮肤软组织缺损的方法及临床疗效。方法:2006年11月至2013年2月,分别采用改良菱形瓣、局部旋转推进瓣、鼻唇沟瓣、颊部粘膜瓣、颞浅筋膜瓣等治疗颜面部外伤及病损148例。结果:术后各皮瓣均存活良好,创面均Ⅰ期封闭,无血肿、感染及坏死,术后美容效果满意。结论:应用整形外科技术及方法,治疗颜面部各类皮肤创伤及病损,术后愈合快、外形满意。     

局部皮瓣在耳廓部分缺损修复术中的应用

目的:探讨局部皮瓣在耳廓部分缺损修复术中的应用。方法:选择耳前局部皮瓣、皮下蒂皮瓣、改良菱形皮瓣及耳后局部皮瓣修复耳廓组织缺损。结果:本组患者术后伤口均Ⅰ期愈合,皮瓣移植成活,无坏死,肤色及质地正常,瘢痕较隐蔽。随访6个月以上,耳廓外形满意,瘢痕不明显。结论:局部皮瓣在耳廓部分缺损修复术中的应用,效果理想,值得临床应用。