外鼻肿瘤术后局部皮肤缺损Ⅰ期皮瓣修复的两种方法

摘要：目的探讨在外鼻肿瘤术后局部皮肤缺损中Ⅰ期皮瓣修复的两种方法，而尖端折叠鼻唇皮瓣修补与眉间跨鼻双瓣修补，分析其临床疗效。方法回顾性分析外鼻肿瘤切除术后，根据不同缺损部位选择不同的Ⅰ期修复方法。鼻翼及鼻背缺损用尖端折叠带蒂鼻唇沟皮瓣修复方法(9例)，眉间缺损选择跨鼻皮瓣修复方法（6例）。 结果15例患者术后随访3个月到1年，鼻部及周围皮肤无明显畸形，皮瓣均成活，血运好，皮瓣色泽红润、大小匹配，无明显瘢痕形成。结论外鼻肿瘤切除后不同区域选择不同的修复方法，重建鼻部基本轮廓，保持鼻部及面部外形及结构的完整性，提高美学效果、患者对手术的满意度及术后的生活质量。

One-stage repair of skin defect after tumor resection of external nose with two kinds of flaps

Abstract:ObjectiveTo introduce two kinds of flaps for one-stage repair of local skin defect after nasal tumor resection, and explore their effect for repair. The adopted flaps were the nasolabial fold wrapped perforator flap and the across-nasal bilobed skin flap.MethodsClinical data of 15 patients with local skin defect after tumor resection of external nose and repaired simultaneously with flaps were analyzed retrospectively. According to the location and size of skin defect, the flaps for repair were circumspectly designed. The nasolabial fold wrapped perforator flap was used to repair skin defect located at nasal alar and nasal dorsum in 9 cases, and the across-nasal bilobed skin flap was applied to glabellum defect in 6.ResultsAll patients were followed up for 3 months to 1 year postoperatively. The flaps survived in all 15 cases with good blood circulation after operation. No obvious malformations or scar formation were observed in the nose and the surrounding skin. The color and size of the flaps were similar to those of recipient sites.ConclusionWith advantages of reconstructing basic nasal contour, keeping structural integrity and maintaining the function of nose and facial appearance, the nasolabial fold wrapped perforator flap and the across-nasal bilobed skin flap are helpful to improve the aesthetic effect and advance the patients contentment as well as the quality of life.