面部皮肤缺损几何分解后局部皮瓣修复

目的：介绍面部皮肤缺损几何分解后联合多个或多种局部皮瓣修复的经验与体会。方法：在修复面部较大范围、形状不规则或跨越面部不同美容分区的皮肤软组织缺损时,根据创面的大小、形状、部位及周围皮肤松动情况,将创面进行几何分解成2个或2个以上的规则形状的缺损,分别以相应的局部皮瓣联合修复创面。结果：对64例患者进行手术,术后创面均Ⅰ期愈合,皮瓣成活良好。47例获随访3～12个月,修复皮瓣与周围皮肤组织的色泽、质地相近,切口瘢痕平软且较隐蔽,面部轮廓无明显牵拉影响。结论：采用将面部创面几何分解后联合多个或多种局部皮瓣修复的方法,可以获得满意的面部形态和美容修复效果。

Facial reconstruction using local flaps after geometry segmenting the defect on the face

Objective To introduce experience with facial reconstruction using combined local flaps after geometry segmenting the defect on the face. Methods Based on the size,shape,location of defect and the surrounding skin,the defect which was large scale,irregular shape or bridged facial cosmetic units was segmented into two or more segments of regular shape,then segmental repair was performed with relevant local flaps in combination. Results 64 patients underwent such operation. All the wound healed at Ⅰ stage and all flaps survived well after operation. 47 cases were follow-up for 3～12 months. The color and characteristics of replaced tissue was similar to those of the surrounding tissue. Incision lines were obscured. Facial contours were restored without distorting surrounding structures. Conclusion Segmenting the wound into smaller units and combining two or more relevant local flaps were useful to develop a reconstruction plan to repair the facial defect and to provide consistently satisfying facial contours and aesthetic results.