摘要
目的探讨额部无可供扩张的皮肤时。全鼻瘢痕畸形修复的疗法。方法借刖全鼻冉造术的原则，采用扩张后前臂任意刮皮瓣带蒂转移修复烧伤后全鼻瘢痕畸肜。扩张器均置在前臂屈侧，置入扩张器切口可根据转移时选择蒂部的不同，选择在近侧、远侧或侧方。扩张完成后，扩大鼻孔、矫正外翻鼻翼，将鼻作为一个解削单元松解，据面部轮廓大小设计修复鼻的大小。可将鼻背瘢痕及扩张皮瓣包膜作为衬垫鼻背的材料。供区直接拉拢缝合，3周后断蒂。结果15例，近端蒂3例，远端蒂11例，侧力蒂1例，皮瓣均成活良好，外观佳。远端蒂组为逆行皮瓣，但血运可靠，与近端蒂组及侧方蒂组比较，县有供区缝合容易、制动体位舒适、皮瓣蒂长、活动度大。可提供较多组织修复缺损等优点。结论额部兀可供扩张皮肤时，应用前臂任意型皮瓣扩张后行企鼻瘢痕畸形修复术，是一个可供选择的方法。
Objective To explore the method of total nasal reconstruction when the forehead skin for expanding is unavailable. Methods According to the principle of total nasal reconstruction, total nasal scar and deformity were repaired with expanded random forearm falp. All the expanders were placed in flexor side of forearm. The incision sides were placed in proximal, distal, or lateral part of the forearm according to different pedicles. After expansion, the nares were enlarged, eversion of ala nasi corrected, the conlracture scars sufficiently released, and the size and shape of the reconstruc-tive nose designed according to face size. The scar of nasal dorsum and capsule of the expanded flap could be used for reconstructing nasal dorsum. Donor sides could be sutured directly, the pedicle could be cut 3 weeks later. Results All the flaps survived with good appearances, and 3 of the 1,5 cases with proximal, 11 with dislai, and 1 with lateral pedicle. The effect of distal pediele group was better than that in proximal and lateral pedicle group because of comfortable posture longer pedicle, and providing more tissue for reconstruction. Conclusions Total nasal reconstruction with expanded random forearm flap is an option when the forehead skin for expanding is unavailable.
出处
《中华医学美学美容杂志》
2013年第1期5-7,共3页
Chinese Journal of Medical Aesthetics and Cosmetology
