中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (9): 729-731.doi: 10.35541/cjd.20190594

• 皮肤外科 • 上一篇    下一篇

脂肪蒂皮瓣在修复皮肤肿瘤切除术后面部缺损中的临床疗效观察

罗显雁    彭建中    王涛    岳超    许如意   

  1. 杭州市第三人民医院皮肤科  310009
  • 收稿日期:2019-05-20 修回日期:2020-01-03 发布日期:2020-08-31
  • 通讯作者: 彭建中 E-mail:957889307@qq.com

Clinical observation of fat pedicled flap in repairing facial defects

Luo Xianyan, Peng Jianzhong, Wang Tao, Yue Chao, Xu Ruyi   

  1. Department of Dermatology, The Third People′s Hospital of Hangzhou, Hangzhou 310009, China
  • Received:2019-05-20 Revised:2020-01-03 Published:2020-08-31
  • Contact: Peng Jianzhong E-mail:957889307@qq.com

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摘要： 【摘要】 目的 探讨脂肪蒂皮瓣在修复皮肤肿瘤切除术后面部缺损中的临床疗效。方法 回顾分析了杭州市第三人民医院皮肤科收治的39例面部肿瘤患者的临床资料，男20例，女19例，年龄55 ± 7.3岁（范围42 ~ 80岁），包括基底细胞癌15例，鳞状细胞癌10例，角化棘皮瘤5例和日光角化病9例。术后缺损面积1.5 cm × 3.0 cm ~ 8.0 cm × 4.5 cm。所有患者均接受肿瘤切除术后缺损脂肪蒂皮瓣修复治疗，术后24 h观察皮瓣存活情况，术后1、3个月及之后每3个月进行随访，观察皮瓣的外形、质地及与周围组织的匹配度等。结果 39例患者术后24 h，切口均无感染，皮瓣存活良好；2例皮瓣远端部分坏死，其皮瓣长与蒂宽比大于3∶1，为下睑部缺损，经处理后创面愈合。术后1个月，3例出现外观臃肿，其皮瓣长与蒂宽比分别小于2∶1、2∶1 ~ 3∶1、大于3∶1，其中2例为上唇部缺损，1例位于面颊部。所有患者随访1 ~ 12个月，平均7个月，皮瓣色泽和质地较好，供皮区和受皮区在功能和外形上均达到良好效果。结论 采用脂肪蒂皮瓣治疗面部皮肤缺损，临床疗效显著，皮瓣组织成活率高，安全可靠，同时对供区损伤较小。

关键词: 外科皮瓣, 外科手术, 皮肤肿瘤, 面部, 皮肤缺损

Abstract: 【Abstract】 Objective To evaluate clinical efficacy of pedicled fat flap in the repair of facial defects after skin tumor resection. Methods Clinical data were collected from 39 patients with facial tumors in Department of Dermatology, The Third People′s Hospital of Hangzhou, and analyzed retrospectively. There were 20 males and 19 females, aged 55 ± 7.3 years （range, 42 - 80 years）, including 15 with basal cell carcinoma, 10 with squamous cell carcinoma, 5 with keratoacanthoma and 9 with solar keratosis. Postoperative skin defects varied from 1.5 cm × 3.0 cm to 8.0 cm × 4.5 cm in size. All patients received skin defect repair with pedicled fat flaps after tumor resection. Twenty?four hours after the surgery, survival condition of the flaps was observed. These patients were followed up at 1, 3 months after the surgery and every 3 months thereafter, and the shape and texture of the flaps and their matching degree with surrounding tissues were evaluated. Results Twenty?four hours after surgery, the flaps survived well without infection in the 39 patients. Partial necrosis was observed at the distal end of the flaps in 2 cases, whose skin defects were on the lower eyelid, with the ratio of the flap length to pedicle width being greater than 3∶1, and wounds were healed after treatment in both of the 2 cases. One month after surgery, bloated appearance was observed in 3 cases, of which 2 cases had defects of the upper lip and 1 had defect of the cheek, and the ratios of flap length to pedicle width were less than 2∶1, 2∶1 - 3∶1, and greater than 3: 1 respectively. All patients were followed up for 1 - 12 months, with an average of 7 months. The color and texture of the flaps were good, and favorable function and shape were achieved in both the donor and recipient sites. Conclusion The pedicled fat flap is markedly effective for the repair of facial skin defects, with high survival rate of flaps, high safety and reliability, and less damage to the donor site.

Key words: Surgical flaps, Surgical procedures, operative, Skin neoplasms, Face, Skin defects