中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (12): 874-876.

• 研究报道 • 上一篇    下一篇

应用三叶皮瓣修复鼻尖部皮肤缺损

杨志勇1,乔丽2,方帆1,蒯飞1   

  1. 1. 中国人民解放军空军总医院
    2. 空军总医院
  • 收稿日期:2015-04-13 修回日期:2015-06-28 出版日期:2015-12-15 发布日期:2015-12-01
  • 通讯作者: 杨志勇 E-mail:yzywxl@163.com

Trilobed flaps for reconstruction of nasal tip defects

  • Received:2015-04-13 Revised:2015-06-28 Online:2015-12-15 Published:2015-12-01

摘要:

目的 探讨应用三叶皮瓣修复鼻尖部皮肤缺损的经验与体会。 方法 23例鼻尖部肿瘤手术切除后皮肤缺损患者,缺损面积1.5 cm × 1.5 cm ~ 2.5 cm × 2.5 cm。根据创面的位置及大小,设计三叶皮瓣进行修复,各瓣叶之间的角度保持在45° ~ 50°,第1个瓣叶与创面的大小相等,第2、3个瓣叶依次缩小,修复过程中尽量保持鼻部美容亚单位的完整性,并利用天然皱褶隐藏瘢痕线。 结果 23例的皮瓣术后全部成活,切口Ⅰ期愈合。23例术后随访6个月至2年,皮瓣与周围皮肤组织的色泽、质地及厚度相近,切口瘢痕隐蔽,鼻翼、鼻孔、鼻小柱及周围器官均未发生畸形,形态满意,功能良好。 结论 三叶皮瓣能有效修复鼻尖部较大面积皮肤缺损并取得良好的形态与功能效果。

Abstract:

Yang Zhiyong, Qiao Li, Fang Fan, Kuai Fei. Department of Dermatology, Air Force General Hospital of PLA, Beijing 100142, China Corresponding author: Yang Zhiyong, Email: yzywxl@163.com 【Abstract】 Objective To evaluate the performance of trilobed flaps for reconstruction of nasal tip defects. Methods Totally, 23 patients with nasal tip defects after tumor resection were enrolled into this study. Skin defects varied from 1.5 cm × 1.5 cm to 2.5 cm × 2.5 cm in size. According to the location and size of skin defects, trilobed flaps were designed, and the angle between two lobes ranged from 45° to 50°. The size of the first lobe was approximately equal to that of the skin defect, while the size of the second and third lobes decreased successively. During flap design, the integrity of nasal subunits was sufficiently considered, and the incision lines were placed along the boundary lines of the nasal subunit as far as possible, so as to conceal the incision scar with natural skin folds. Results After the operation, skin flaps survived with primary healing of incisions in all the patients. After 6 - 24 months of follow up, the color, texture and thickness of flaps were similar to those of their surrounding skin, and incision scars were inconspicuous. No malformation occurred in the nasal ala, nostril, nasal columella or surrounding organs, and satisfactory nasal appearance and function were achieved. Conclusion Trilobed flaps can be used to effectively repair relatively large skin defects of the nasal tip with satisfactory nasal appearance and function.