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董 栋1 杨 枫2 李玲芝2 周琼艳2 应孟夏2 许素玲2▲ 李玉玲3.眉间-上睑双叶皮瓣联合鼻唇沟推进皮瓣修复内眦及鼻背皮肤缺损16例[J].中国现代医生,2021,59(15):23-26+封三
眉间-上睑双叶皮瓣联合鼻唇沟推进皮瓣修复内眦及鼻背皮肤缺损16例
Repair of 16 cases of skin defect of inner canthus and nasal dorsum with eyebrow-upper eyelid bilobate flap combined with nasolabial groove advanced flap
  
DOI:
中文关键词:  皮肤肿瘤  外科皮瓣  内眦缺损  鼻背缺损  美容单位
英文关键词:Skin tumor  Surgical flaps  Defect of inner canthus  Defect of nasal dorsum  Cosmetic unit
基金项目:浙江省宁波大学青苗基金(FYQM-LC-202008);浙江省宁波市自然科学基金(一般项目)(202003N4280);浙江省医药卫生科技计划项目(2021KY314)
作者单位
董 栋1 杨 枫2 李玲芝2 周琼艳2 应孟夏2 许素玲2▲ 李玉玲3 1.宁波大学医学院附属医院手显微外科-皮肤整形修复中心浙江宁波 3150202.宁波大学医学院附属医院皮肤整形修复中心浙江宁波 3150203.宁波大学医学院附属医院内分泌科浙江宁波 315020 
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中文摘要:
      目的 探讨应用眉间-上睑双叶皮瓣联合鼻唇沟推进皮瓣修复内眦及鼻背皮肤缺损的手术方法和临床效果。方法 2017 年12 月至2019 年12 月我科收治内眦及鼻背部皮肤肿瘤患者16 例,基底细胞癌14 例,鳞癌2 例,男9 例,女7 例,年龄46~72 岁。切除肿瘤后创面面积(1.5 cm×1.0 cm)~(2.0 cm×4.0 cm)。肿瘤切除后创面采用眉间-上睑双叶皮瓣联合鼻唇沟推进皮瓣修复。结果 本组16 例皮瓣全部成活,内眦及鼻背皮肤缺损区、眉间-上睑及鼻唇沟供瓣区均一期闭合,术后内眦角及鼻背形态良好,皮瓣与周围皮肤色泽、质地相近,切口瘢痕隐藏于鼻唇沟及眉间纹,术后随访6~18 个月,未见内眦部及附近组织器官畸形,形态满意,皮肤肿瘤无复发。结论 修复内眦及鼻背跨美容单位皮肤缺损时,眉间-上睑双叶皮瓣能很好地重建内眦角,术后内眦角形态自然,联合鼻唇沟推进皮瓣修复鼻背皮肤缺损,能够最大程度地恢复内眦、鼻背区域美容亚单位的独立性和完整性,手术效果良好。
英文摘要:
      Objective To investigate the surgical method and clinical effect of using the eyebrow-upper eyelid bilobate flap combined with nasolabial groove advanced flap to repair the skin defect of inner canthus and nasal dorsum.Methods From December 2017 to December 2019,a total of 16 patients with skin tumors of the inner canthus and nasal dorsum,14 with basal cell carcinoma and 2 with squamous cell carcinoma were admitted to our department,including 9 males and 7 females,aged between 46 and 72 years.The wound areas after tumor resection were (1.5 cm×1.0 cm)-(2.0 cm×4.0 cm).After tumor resection,the eyebrow-upper eyelid bilobate flap combined with nasolabial groove advanced flap was used to repair the wound.Results In the group,all of the 16 flaps survived,and the skin defect areas of the inner canthus and nasal dorsum,the eyebrow-upper eyelid and the donor flap areas of the nasolabial groove were closed in the first stage.Postoperatively,the inner canthus and nasal dorsum were in good shape;the skin flaps were similar to the surrounding skins in color and texture;the incision scars were hidden in the nasolabial grooves and the glabellar lines.No tissue and organ malformations were found at the inner canthus and its vicinity in the postoperative follow-up for 6 to 18 months,with satisfactory morphology and no recurrence of skin tumor.Conclusion When repairing the cross cosmetic unit skin defect of the inner canthus and the nasal dorsum,the eyebrow-upper eyelid bilobate flap can reconstruct the inner canthus very well,and the inner canthus is naturally shaped postoperatively.Repair of skin defect of nasal dorsum with eyebrow-upper eyelid bilobate flap combined with nasolabial groove advanced flap can restore the independence and integrity of the cosmetic subunits of the inner canthus and nasal dorsum to the greatest extent,and the surgical effect is good.
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