局部皮瓣在修复外鼻小面积皮肤缺损中的应用

目的：探讨应用外鼻临近局部皮瓣修复外鼻小面积缺损的方法与临床疗效。方法：42例鼻小面积缺损（直径〈2cm）的患者分别应用外鼻局部皮瓣（鼻背瓣、鼻唇沟瓣和双叶瓣）修复。皮肤恶性肿瘤切除后缺损38例，皮肤其他良性病变4例，缺损直径1～2cm。鼻尖缺损7例采用鼻背旋转皮瓣一期修复；鼻侧部缺损30例采用鼻唇沟瓣修复，其中使用岛状鼻唇沟瓣一期修复7例，插补式皮瓣二期修复18例，滑行瓣修复5例；鼻侧上方缺损5例采用双叶瓣一期修复。结果：所有患者均修复成功，组织皮瓣全部成活。患者平均随访3个月～2年，肿瘤无复发。结论：外鼻局部皮瓣如鼻背瓣、鼻唇沟瓣和双叶瓣是修复鼻部小面积皮肤缺损的有效方法，疗效满意。

Reconstruction of external nose defect with local flaps

Objective： The role of different local flaps in small external nasal skin defect reconstruction was discussed. Method：Forty-two cases of the small size nasal defects（diameter~2 cm） were repaired with local exter- nal nose flap（includes the dorsal nasal flap, nasolabial flap and biobed flap）. The clinical and follow-up data were analyzed of patients with small external nasal skin defects, who accepted different local flaps reconstruction. Dor- sal nasal flap, nasolabial flaps （includes island flap, slid flap and axial flap） and bilobed flap were tailored to re- construct different external nasal defect. Twenty-seven patients were male and fifteen patients were female, the pa- tients. age ranged from 28 to 74 years, the median age was 61 years. Thirty-eight cases resulted from resection of skin malignant tumor and four cases were benign lesions. The diameter of defects was 1-2 cm. The defects were reconstructed by single-stage dorsal nasal flap in 7 cases. There were 30 cases of caudolateral nasal defects were reconstructed by nasolabial flap, single-stage island nasolabial flap in 7 cases, axial flap in 18 cases and slid flap in 5 cases. Superior lateral defects were reconstructed by single-stage bilobed flap in 5 cases. Result： All defects were repaired successfully. All tissue flaps survived and had not necrosis. There was no tumor recurrence during 3 months to 2 years follow-up. Conclusion：The dorsal nasal flap, nasolahial flap and bilobed flap can be used safely and effectively to repair the small external nasal defect and have satisfactory curative effect.