颞浅筋膜预构颈部扩张皮瓣修复大面积面部缺损的临床研究

目的 观察颞浅筋膜瓣预构颈部扩张皮瓣,修复大面积面部缺损的效果。方法 2013年6月至2015年3月,应用颞浅筋膜瓣预构颈部扩张皮瓣,治疗10例大面积面部缺损患者。分离颞浅筋膜瓣,返折后固定于颈部预扩张皮瓣下方,并放置扩张器;经5~6个月的扩张获得足够的新生皮肤后,设计皮瓣,形成以颞浅筋膜为蒂的岛状皮瓣,将皮瓣转移修复面部缺损。结果 颞浅筋膜瓣预构颈部皮瓣后,可使扩张量达到400~800 m L,平均修复面积为129 cm2,大小8 cm×9.5 cm~14 cm×14 cm。扩张过程中未出现缺血、坏死等并发症。本方法成功修复10例患者的面部缺损,术后随访6~12个月,皮瓣色泽、质地与面部皮肤接近。结论 采用颞浅筋膜瓣预构颈部扩张皮瓣,可有效增加扩张皮肤血液供应,从而获取较大面积的扩张皮肤进行面部修复。

Clinical Application of the Expanded Neck Flap Prefabricated by Superficial Temporal Fascia for Facial Resurfacing

Objective To explore the clinical effect of the expanded neck flap prefabricated by superficial temporal fascia for facial resurfacing. Methods From June 2013 to March 2015, 10 patients with large facial deformity were treated with the expanded neck flap prefabricated by superficial temporal fascia. The superficial temporal fascia was separated, rotated reversely, and located beneath subcutaneous tissue of the planned expanded neck area over a tissue expander. After expansion for 5-6 months to achieve enough volume, the expected resurfacing shape was designed and raised, and an island flap based on superficial temporal fascia was harvested and rotated to resurface the facial defect. Results The expansion volume reached 400-800 ml after prefabrication. The flap size ranged from 8 cm × 9.5 cm to 14 cm × 14 cm, with an average area of 129 cm2. Ten patients were treated by this method, and there were no major complications in the expansion process, such as ischemia and necrosis. All the patients were followed up for 6 months to 1 year, there was an excellent color and texture match with surrounded facial skin. Conclusion The blood supply could increase effectively after being prefabricated with superficial temporal fascia, and more expanded skin could be harvested to repair large facial defect.