摘要
目的:探讨游离股前外侧筋膜脂肪瓣联合人脱细胞异体真皮修复半侧颜面萎缩畸形的效果。方法:2008年1月至2020年12月,北京协和医院整形美容外科收治各种原因所致半侧颜面萎缩患者19例,男3例、女16例,年龄16~56(29±10)岁。一期手术根据半侧颜面萎缩范围设计获取游离股前外侧筋膜脂肪瓣,与面部血管显微吻合后填充入凹陷部位。二期手术对皮瓣进行修整并根据面部亚单位凹陷情况用人脱细胞异体真皮填充。结果:19例患者皮瓣存活良好,但均出现不同程度的面部亚单位组织萎缩,主要表现在眶下、鼻唇沟、颞部等部位,用脱细胞异体真皮填充修复,经1~8年随访填充效果较好,无明显排异反应。19例患者中18例出现不同程度皮瓣肥厚,经常规吸脂或皮瓣修薄手术改善。随访1~8年,19例患者恢复较好。结论:人脱细胞异体真皮能弥补游离股前外侧筋膜脂肪瓣矫正半侧颜面萎缩的局限性,二者联合使用能够达到更好的治疗效果,值得临床应用。
Objective To investigate the clinical effect of facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix.Methods Nineteen facial depression patients(3 males and 16 females),age ranges from 16 to 56 years(average age:29.1±10.37 years),caused by different reasons were selected in this research from Jan.2008 to Dec.2020.In the stage I operation,anterolateral thigh adipofascial flap was designed according to facial depression area and harvested to fill in the depression with vascular anastomosis;In the stage II operation,the human acellular dermal matrix was used to fill in the remained depression edge according to facial subunit.Results All free anterolateral thigh adipofascial flap survived well.All patients revealed fascial subunit tissue atrophy of different degree in infraorbital,nasolabial sulcus and temporal areas which were repaired by using cellular dermal matrix and obtained satisfying effect during 1 to 8 years of follow-up with no obvious rejection.18 of 19 patients showed flap hypertrophy and corrected by liposuction.All patients recovered well after 1 to 8 years of follow-up.Conclusions Humana cellular dermal matrix could make up the limitations of treating fascial depression deformity when using anterolateral thigh adipofascial flap.The combination method of above approaches could obtain satisfying clinical effect,which is worthy of clinical promotion.
作者
张明子
李之瑾
李海瑞
邱子锴
刘志飞
王阳
斯楼斌
曾昂
Zhang Mingzi;Li Zhijin;Li Hairui;Qiu Zikai;Liu Zhifei;Wang Yang;Si Loubin;Zeng Ang(Department of Plastic Surgery,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中华医学美学美容杂志》
2022年第1期22-25,共4页
Chinese Journal of Medical Aesthetics and Cosmetology
关键词
面部单侧萎缩
修复外科手术
血管吻合复合组织移植
股前外侧筋膜脂肪瓣
脱细胞异体真皮
Facial hemiatrophy
Reconstructive surgical procedures
Vascularized composite transplantation
Anterolateral thigh adipofascial flap
Human acellular dermal matrix
