上臂内侧逆行皮管修复面中部洞穿缺损与鼻缺损

【作者】 马少林； 秦涛； 乔星；

【机构】 新疆医科大学第一附属医院整形外科；

【摘要】 1.目的:探讨总结应用上臂内侧逆行任意皮管修复面中部洞穿缺损与鼻缺损的方法与经验。2.方法:Ⅰ期手术于患者上臂内侧按皮管长宽比形成原则设计制备上臂内侧皮管,卷成管前皮瓣面积最大为14cm×8cm,最小为12cm×7cm;皮管近心端可靠夹管训练后行Ⅱ期手术予以离断,形成蒂位于远端近肘关节内侧的逆行任意上臂内侧皮管,皮管转移将近心端缝和固定于至面中部缺损鼻缺损或部位:再行皮管远心端蒂部可靠夹管训练,Ⅲ期手术离断远心端蒂部,修复面中部缺损或鼻缺损。3.结果:7例应用上臂内侧逆行任意皮管病例中,2例为面中部洞穿性缺损皮管直接修复,5例为毁损性鼻缺损皮管转移到位后展开修复,术后皮管均未出现血运障碍,获得满意临床疗效。4.结论:应用上臂内侧逆行任意皮管修复面中部洞穿缺损与鼻缺损方法简单易于掌握,虽然存在手术次数较多、治疗周期较长、需要一定时间被迫体位等不足,但手术承担风险相对较小、技术要求相对较低、皮管提供的修复组织量较多,是修复面中部洞穿性缺损与毁损性鼻缺损的一种有效方法。更多还原

【Abstract】 Objective:To inquire into and summarize the methods and experience of repairing the middle facial defect using the medial upper arm reverse tubed flap. Method:At first stage,the medial upper arm tubed flap is harvested according to the plan principles of length-width ratio of tubed flap;the maximum area of the tubed flap is 15cm×8cm and the minimum area of the tubed flap is 14cm×7 cm.The paracentral end of the tubed flap is cut after blood flow block training at second stage,forming the medial upper arm reverse tubed flap which is transferred and fixed to the regin of the middle facial defect.Also after blood flow block training at third stage,cutting of the pedicle or distal end the tubed flap is carried out and the middle facial defect is repaired.Result:There are 7 patients with middle face defect repaired by the medial upper arm reverse flap,two of them suffer from hole defect of middle face and others severe nose defect.There are no necrosis in these flaps and satisfactory result is gained. Conclusion:It is easy for us to repair the middle facial defect and severe nose defect using the medial upper arm reverse flap.Althrough there are some disadvantages like more operative times,longer hospilzation and some passive position,the medial upper arm reverse flap is also one of the effective methods reparing the middle facial defect and severe nose defect with the advantages of less operative risk,more simple operative technique and more tissue amount available.更多还原