局部皮瓣修复面部皮肤恶性肿瘤软组织缺损疗效观察

目的探讨局部皮瓣修复面部皮肤恶性肿瘤软组织缺损的有效性及安全性。方法面部皮肤恶性肿瘤患者40例，其中基底细胞上皮瘤27例，鳞状细胞癌6例，恶性黑色素瘤3例，隆突性皮纤维肉瘤2例，角化棘皮瘤恶变及皮脂腺癌各1例，均行手术广泛切除肿瘤，手术软组织缺损应用局部皮瓣移植修复。结果40例均I期修复，局部皮瓣全部存活，术区外形和功能满意；术后随访24个月，鳞状细胞癌局部复发1例，鳞状细胞癌及黑色素瘤各1例发生颈部淋巴结转移，1例黑色素瘤发生肺转移，余无局部复发和转移。结论手术广泛切除是治疗面部皮肤恶性肿瘤的主要方法，局部皮瓣可修复手术皮肤软组织缺损，是保证手术治疗顺利开展的关键。

Effect of local skin flap on repairing facial skin malignant tumor

Objective To explore the efficacy and safety of local skin flap in repairing soft tissue defect in facial skin malignant tumor. Methods In 40 cases of skin malignant tumor, there were 27 cases of basal cell epithelioma, 6 cases of squamous cell carcinoma, 3 cases of malignant melanoma, 2 cases of dermatofibrosarcoma protuberans, 1 case of keratoacanthoma and 1 case of sebaceous carcinoma. All received wide excision of soft tissue and the defects were repaired with local skin flap. Results All these 40 cases were repaired in stage I , and local skin flaps survived with satisfactory appearance and function. All patients were followed up for 24 months. Squamous cell carcinoma was locally relapsed in 1 case, lymphatic metastasis occurred in 1 case of malignant melanoma and 1 case of squamous cell carcinoma, and pulmonary metastasis was found in 1 case of malignant melanoma. Conclusions Wide excision is the main method for facial skin malignant tumor. Local skin flap can repair soft tissue defect in facial skin malignant tumor.