摘要
目的探讨外眦角颞侧水平带蒂皮瓣在下睑瘢痕性外翻修复中的应用。方法对11例(11只眼)伴有皮肤组织缺损的下睑外翻患者实施该手术,其中3只眼为局部疖肿溃破后皮肤瘢痕挛缩,2只眼为铝水烫伤后,6只眼为皮肤挫裂伤后。年龄15～58岁。局麻下手术,根据下睑皮肤缺损范围,在颞区设计一以肌肉组织为蒂的水平向皮瓣。皮瓣穿过供、受区之间的皮下隧道后缝合于缺损区。结果术后第2天,有1只眼皮瓣的鼻侧端微紫,1周后色泽日趋正常。术后随访3～6个月,11只眼下睑皮瓣色泽良好,与周围组织差异小,无外翻发生。颞区伤口瘢痕细而淡。结论颞区水平皮瓣在伴有皮肤组织缺损的瘢痕性下睑外翻修复中疗效良好,供区水平伤口愈合佳,瘢痕小。但供皮量受颞区皮肤松弛程度的限制,且应严格控制皮瓣长度,避免因血供不足造成组织坏死,因而更适合于下睑颞侧半皮肤缺损的修复。
Objective To discuss the application of horizontal pedicle flap at the temporal area to lateral canthus in restoration of lower eyelid cicatricial ectropion.Methods The surgical procedure was done on 11cases of lower eyelid ectropion with skin tissue defects,including 3 cases of scar contracture after the burst of local furuncle,2 cases of scald wound burned by aluminum water,6 cases of eyelid skin laceration,patients＇ age ranged from 15~58 years old.Surgeries were done under local anesthesia,design the horizontal temporal flap with its muscle tissue pedicle according to the extent of lower eyelid defect.The Flap was sutured on the defect area after passed through the subcutaneous tunnel between the donor site and recipient site.Results 2 days after surgeries,the flap color of 1 case present with a slight purple at the nasal side,the color turned back to normal after one week.The color of the 11 flaps was good and similar to the surrounding skin with little difference,and there was no ectropion occurred during 3~6 months postoperative follow-up.The scar of temporal incision were small and with light pigment.Conclusion The outcome of applying horizontal temporal flap in repairment of cicatricial lower eyelid ectropion with eyelid skin tissue defect is good.The healing of donor site wound is good and leaves small scar.However,the volume of donor skin is limited by laxity of the temporal skin.And the length of the flap should be controlled strictly to avoid the necrosis caused by flap ischemia.Therefore,this method is more suitable for temporal side defects of lower eyelids.
出处
《临床眼科杂志》
2010年第3期233-234,共2页
Journal of Clinical Ophthalmology
基金
上海市重点学科建设项目(编号:S30205)
关键词
瘢痕性下睑外翻
皮肤缺损
皮瓣修复
Cicatricial lower eyelid ectropion
Skin defect
Flap reconstruction
