游离皮瓣移植在眶窝缺损修复中的应用

目的 探讨游离皮瓣移植修复眶窝缺损的可行性和应用价值。方法 2001年1月至2005年8月，27例眶窝缺损的患者中有24例采用了游离前臂皮瓣，2例采用了游离肩胛皮瓣，1例采用了游离腹直肌皮瓣。对其临床效果进行评价。结果 术后随访10-66个月，以健侧为参照，所有患者皮瓣皮肤色泽均接近健侧，义眼配戴良好，24例游离前臂皮瓣移植中15例术后出现上睑凹陷，其中4例其凹陷程度3mm；2例游离肩胛皮瓣移植和1例游离腹直肌皮瓣移植术后眶窝比较丰满。结论 游离皮瓣移植对修复重度眶窝缺损或畸形是一种有效的方法。一般情况多采用游离前臂皮瓣移植，对于眶窝空旷程度极其严重的可采用游离肩胛皮瓣移植，游离腹直肌皮瓣移植对于眶窝伴上颌骨等其他组织大量缺损的病例修复效果比较好。

Eye socket reconstruction with free flap

Objective To investigate the feasibility of reconstruction of the defect of the orbital region with free flaps in the retrospective study.Method 27 free flaps were transferred to reconstruct the defects in the orbital region in 27 patients from January 2001 to August 2005. Of the 27 free flaps,24 cases were forearm free flaps,2 cases were scapular free flaps and 1 case was rectus abdominis myocutaneous free flap. Results With a follow-up between 10 to 66 months, the colour and luster was approximate to the normal sides, and well-fitted eye prosthesis was weared in all cases. Conclusion Free flap transhtion is an effective method for the eye socket reconstruction. Forearm free flap is generally used. The scapular free flap could be used in the much severely hollow eye socket.With respect to large orbital defects combine with other maxillofacial defects, the rectus abdominis myocutaneous free flap might be better.