头面部皮肤恶性肿瘤切除与整形修复

目的:回顾性分析和总结头面部皮肤恶性肿瘤手术和修复的临床经验。方法:扩大切除头面部皮肤恶性肿瘤44例,对47处缺损分别采用直接拉拢缝合、游离植皮、各种邻近皮瓣、皮肤软组织扩张术、游离大网膜 皮片移植等方法修复。结果:因皮瓣下血肿致延期愈合1例,大网膜坏死而重新植皮1例,面神经麻痹2例,部分皮片坏死2例,其余的病例均Ⅰ期愈合。结论:术后缺损的修复方法应根据患者的具体情况而定,其中以邻近随意皮瓣的效果较好。

Resection and reconstruction of the craniofacial skin malignancies

Objective:To review clinical experience in plastic treatment of the craniofacial skin malignancies.Methods:Forty-four patients of skin malignancies were treated by surgical resection extensively, 47 defects were closed by direct closure (13 cases), skin graft (12), random flaps (19 cases ), tissue expansion (2 cases ), free transplantation of epiploon plus skin graft (1 case ),respectively. Results:Six defects developed complications including hematoma of the distal flap in 1 patient, necrosis of the free epiploon in 1 patient, facial paralysis in 2 patients, necroses of minor part of graft in 2 patients. Other 41 defects were repaired by first intention. The hair grew well and the scars were hidden with a satisfactory appearance in scalp flap. Conclusion:The method for repairing the postoperative defect should be individualized according for the benefit of patients, including which randomized flap could yield best cosmetic results.