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目的 探讨“风筝”皮瓣(亦称皮下蒂推进皮瓣)在修复眼睑前层(包括皮肤和眼轮匝肌)缺损的应用。方法 于缺损邻接部位沿皮纹方向设计“风筝”皮瓣,按设计线切开皮肤, 在眼轮匝肌下剥离形成以眼轮匝肌为皮下蒂的“风筝”皮瓣,推进转移修复皮肤缺损,用7 0无损伤缝线缝合。自 1994 年以来已用于14例,年龄15~64岁,缺损最大直径为上睑长度的 1/3。结果 皮瓣全部成活,切口Ⅰ期愈合,随访时间3个月至1年, 眼睑形态满意,切口瘢痕不明显。结论 对于眼睑前层范围较大不宜直接缝合,但尚有条件用局部皮瓣修复的中等大的缺损,用“风筝”皮瓣进行修复简单易行,效果可靠。其优点是,皮瓣通过推进转移的方式覆盖创面,没有旋转和变形,转移后局部平整,无“猫耳”等畸形产生,皮瓣蒂部宽广,血运良好,愈合后肤色与四周一致。
Objective To investigate the application of “kite” flap (also known as subcutaneous pedicle propulsion flap) to repair the defect of anterior eyelid (including skin and orbicularis oculi muscle). Methods Kite flaps were designed along the dermatoglyphics at the defect abutment site. The skin was cut according to the design line and a “kite” flap with the orbicularis oculi muscle subcutaneously dissected under the orbicularis oculi muscle was disseminated to repair the skin Defect, suture with 70 non-destructive suture. Has been used since 1994, 14 cases, aged 15 to 64 years, the maximum diameter of the defect is 1/3 of the length of the upper eyelid. Results All the flaps survived. The incisions healed by first intention. The follow-up time ranged from 3 months to 1 year. The shape of eyelid was satisfactory and the incision scar was not obvious. Conclusion For the larger eyelid anterior layer should not be directly sutured, but there are still conditions with local flap repair of large defects, with “kite” flap repair simple, reliable results. The advantage is that the flap covers the wound by means of propelling and transferring, without rotation and deformation, local flattening after the transfer, no deformities such as “cat’s ear” and the like, and the pedicle flap is wide and blood supply is good.