颞浅动脉顺行岛状皮瓣修复重度眼睑及眶周组织缺损

目的探讨颞浅动脉顺行岛状皮瓣修复重度眼睑及眶周组织缺损的适应证、安全性和有效性。方法根据颞浅血管的解剖分布，制备以颞浅动脉为蒂形成的顺行岛状皮瓣，通过皮下隧道移转至缺损区，修复各种原因所致的重度眼睑及眶周组织缺损患者18例（18眼）。术后随访6个月，观察皮瓣存活、眼睑功能恢复情况和手术效果。结果16例皮瓣完全存活，皮瓣颜色与受区皮肤相近，质地柔软，皮瓣感觉功能良好，睑裂闭合良好，外观满意。1例术后早期出现静脉回流障碍，经积极处理，皮瓣远端有小片表皮坏死。1例皮瓣因严重静脉淤滞坏死，术后3个月行游离植皮术，植皮存活。6例患者因皮瓣肿胀，行Ⅱ期修整术。结论颞浅动脉顺行岛状皮瓣具有血供丰富、色泽质地与受区相近等优点，是修复重度眼睑及眶周组织缺损并重建眼睑功能和外观理想的皮瓣。

Clinical application of superficial temporal artery island flap in the reconstruction of eyelid and periorbital defect

Serious defect of eyelid and periorbital tissue affects the appearance of patients and closure-eye function.Application of superficial temporal artery island flap to repair the defected tissue is considered to be an available method to reconstruct eyelid and periorbital tissue.ObjectiveThis study aims to investigate the indication,safety and effectivity of reconstructing the serious defect of eyelid and periorbital tissue by forward flow flap.MethodsEighteen eyes of 18 cases with serious eyelid and periorbital tissue defect were reconstructed by covering the defect zone with superficial temporal artery to form forward flow flap.The flap was made along the distribution of superficial temporal artery with the size over the tissue detect area and transferred to lesion via subcutaneous tunnel.The follow-up time was 6 months.Survival status of flap,plastic condition of lesion and surgical treatment were discussed.ResultsAmong 18 cases with eyelid and periorbital defect,the flaps were survived in 16 cases with the satisfactory repairing appearance,showing nice color,soft texture and normal sensation after plastic surgery.Reconstructed eyelids closed well.One case showed the temporary obstruction of venous refluence in early stage after operation and remained distal epidermal necrosis.Reoperation was performed in 6 patients because of flap hypertrophy and showed a successful outcome.One patients occurred the failure of plastic flap due to hypertrophy and underwent free-flap transplantation in 3 months following the first surgery and obtained a ultimately flap survival.ConclusionThe superficial temporal artery forward flow flap offers a stable and reliable blood supplying and provides adequate tissue of excellent color and texture match.It is an ideal and available flap for the reconstruction of serious eyelid and periorbital tissue defect.