双叶皮瓣在鼻部皮肤缺损修复中的应用

目的探讨应用双叶皮瓣即刻修复鼻部下1/3皮肤软组织缺损的可行性及美容效果。方法选择直径≤2.1 cm,鼻下部1/3皮肤基底细胞癌切除后致鼻部软组织缺损15例患者。肿瘤行手术切除,手术边缘距离肿瘤边界为0.5 cm。切除后鼻部软组织缺损范围最大2.0 cm×2.1 cm,最小1.0 cm×1.0 cm。鼻部皮肤软组织缺损采用邻近双叶皮瓣即刻修复。供区继发创面直接拉拢缝合。结果 15例患者均获得成功,术后创面Ⅰ期愈合,无皮瓣坏死,经1～5年追踪复查,肿瘤无复发。无明显鼻部畸形。修复组织质地、颜色与周围皮肤匹配,鼻部外形较好,美容效果满意。结论双叶皮瓣行鼻部下1/3直径≤2.1 cm皮肤软组织缺损即刻修复是可行的,色泽、质地、轮廓等方面获得较好的匹配和协调,可获得较理想功能及稳定美容效果。

Bilobed Flap for Reconstruction of Nasal Skin Defects

Objective To investigate the feasibleness and the cosmetic outcome of nasal skin defects which located on one third of nasal lower part reconstructed with bilobed skin flap at one stage.Methods Fifteen consecutive patients with basal cell carcinoma that located in the lower third of the nose and less than 2.1 cm in diameter received tumor resection,the distances from incisions margin to the tumor border were 0.5 cm.skin defects sizes following the excision ranged from 1.0 cm×1.0 cm to 2.0 cm×2.1 cm.The bilobed skin flap were designed and transferred to repair the defects.The secondary defect of donor area was directly sutured.Results Primary healing was achieved in all 15 cases without complications.The patients were followed up for 1-5 years.No recurrence of the tumors occurred.There were no obvious postoperative deformities.The color and texture of flaps were matched with the surrounding skin and the nose contour and cosmetic results were satisfactory.Conclusion The bilobed skin flap is simple and effective for the lower third of the nasal skin defects reconstruction less than 2.1 cm in diameter and obtain a good color,contour and texture match with the surrounding skin,provides a good cosmesis in selected cases.