阅读者皮瓣与菱形皮瓣在面部皮肤肿物切除后皮肤缺损重建中的临床应用

目的探讨阅读者皮瓣与菱形皮瓣修复皮肤缺损创面的临床疗效。方法自2018年4月至2019年4月徐州市中心医院整形美容科对皮肤肿物切除后的皮肤软组织缺损患者采用阅读者皮瓣修复6例、菱形皮瓣修复10例,并对其治疗效果及术后并发症等进行回顾性分析;术后3个月随访,对患者的皮瓣色泽、质地及瘢痕等情况通过视觉模拟评分法(visual analogue scale,VAS)评估满意度(非常满意、满意、一般、不满意和非常不满意;依次记为5、4、3、2、1分)。结果16例患者术后皮瓣均未出现动脉供血及静脉回流障碍,皮瓣色泽、质地较好,创面均一期愈合。术后随访3个月,无肿物或色素痣复发,患者的满意度评分为(4.5±0.72)分;术区周围器官未发生移位,切缘无明显瘢痕,外观形态较满意。结论采用阅读者皮瓣与菱形皮瓣修复皮肤缺损创面,操作简单、转移灵活、血运可靠。阅读者皮瓣更适用于修复皮肤缺损面积较大的创面;菱形皮瓣更适用于修复皮肤缺损面积较小的创面。故可根据患者的不同年龄、创面部位及皮肤松弛度来选择不同的修复方法。

Clinical application of reading man flap and Limberg flap in the reconstruction of skin defects after facial mass resection

Objective To explore the clinical efficacy of reading man flap and Limberg flap in the repair of skin defects.Methods Between April 2018 and 2019,6 patients with skin defects after facial mass resection were repaired by reading man flap and 10 patients were repaired by Limberg flap.The efficacy and postoperative complications were retrospectively analyzed.All patients were followed-up for 3 months after operation.The satisfaction degree for color,texture and scar of flap was assessed by visual analogue scale(VAS).The great satisfaction,satisfaction,general satisfaction,not satisfaction and quite unsatisfaction was respectively recorded as 5 points,4 points,3 points,2 points and 1 point.Results No arterial blood supply and venous reflux disorder occurred in 16 patients after operation.The color and texture of flap was good and the wounds healing by first intention.All patients were followed-up for 3 months,there was no recurrence of tumor or pigmented nevus.The scores of patients’satisfaction were(4.5±0.72 points).The organs around the operation area were not displaced.There was no obvious scar in the incision.The appearance was satisfactory.Conclusion The reading man flap and limberg flap has the advantages of simple operation,flexible transfer and reliable blood supply in the repair of skin defects.The reading man flap was suitable for wounds with large area skin defects.The Limberg flap was suitable for wounds with small area skin defects.The appropriate treatment method should be selected according to patient’s age,location of wound and degree of skin laxity.