摘要
目的:探讨遵循解剖特点的A-T皮瓣在面部软组织缺损修复中的应用效果。方法:笔者对22例面部软组织缺损患者行A-T皮瓣修复,根据患者各个区域软组织缺损情况、周边相连组织特点、解剖纹理及langer线走向综合设计遵循解剖特点的A瓣的底边。唇周、鼻翼缘设计在皮肤黏膜交界区;眼周设计线多位于睑缘;眉区设计线多位于眉上或者眉下眉毛和皮肤交界处;睑袋区设计线可在泪沟线;额部近发际线可设计在发际线。根据各区解剖特点,皮瓣切口线可呈弧形、对应线长短不一定相等。将外伤创面或者需切除物设计包含在A瓣内,根据创面或者需切除物大小,沿轮廓线或自然交界线向两侧延长底边至合适长度。沿设计线切开皮肤和皮下组织,掀开皮瓣,对合A瓣底边两点并缝合成T瓣,各对应边对位缝合。结果:22例患者A-T皮瓣修复术后,术区未见明显缺血、瘀血和皮瓣收缩,皮瓣全部存活,切口瘢痕形成不明显。结论:遵循解剖特点的A-T皮瓣在修复面部相关区域软组织缺损时效果较好,对周边形态影响小,瘢痕形成少,值得临床推广应用。
Objective To investigate the effect of A-T flap in repairing facial soft tissue defects.Methods Twenty-two patients with facial soft tissue defects were treated with A-T flaps.According to the soft tissue defect of each area,the characteristics of the surrounding tissue,the anatomical texture and langer line,the base of flap A was designed comprehensively.The labial and nasal flange were designed in the skin mucosal junction area,the design line around the eye is mostly located at the eyelid margin,the eyebrow area design line is mostly located on the eyebrow or at the junction of the eyebrow and the skin.The eye bag area design line can be in the tear groove line,the forehead near hairline can be designed on the hairline.According to the anatomical characteristics of each area,the incision line of the flap can be curved,and the length of the corresponding line may not be equal.The traumatic wound or the part to be removed is designed to be included in the A flap,and the sides are extended to the appropriate length along the contour line or the natural junction according to the size of the wound or the part to be removed.Cut the skin and subcutaneous tissue along the design line,open the flap,close the bottom of the A flap at 2 points and suture it into a T flap,and suture the corresponding edges.Results In 22 cases,there was no obvious ischemia and congestion after flap operation,all flaps survived,no obvious contraction of the flaps,and the formation of incision scar was not obvious.The functional area connected by the flap,such as eye opening,eye closing,mouth opening and mouth closing,has good function,and the shape of the connected area has no obvious change.Conclusion The A-T flap,which follows the anatomical characteristics,has a good effect in repairing the soft tissue defects in the relevant areas of the face.It has less influence on the peripheral morphology and less scar formation,and is worth recommending.
作者
吴晓勇
WU Xiaoyong(Department of Plastic and Burn Surgery,the Jiangyin Hospital Affiliated to Medical College of Southeast University,Jiangyin 214400,Jiangsu,China)
出处
《中国美容医学》
CAS
2023年第10期43-45,共3页
Chinese Journal of Aesthetic Medicine
