Double-opposing rotation-advancement flaps for closure of forehead defects.

Evan R Ransom, Andrew A Jacono
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引用次数: 15

Abstract

Objective: To describe a local flap for closure of forehead defects of all sizes that does not alter the brow position or hairline.

Methods: Retrospective review of 16 cases in which the double-opposing rotation-advancement flaps were used for closure of small (<10 cm2), medium (10-20 cm2), and large (>20 cm2) forehead defects. This technique was developed from Orticochea's method for closure of large scalp wounds.

Results: All 16 patients underwent single-stage closure of forehead defects using our design. Six patients were men, 8 were women (mean age, 71 years). Preoperative defect sizes ranged from 3 to 30 cm2 (mean, 18 cm2). All wounds resulted from Mohs surgery for cutaneous malignant neoplasms; 2 were adjacent to previous reconstructions. No recurrence of tumor was seen during the study period. No permanent frontal branch injuries occurred. One patient developed a moderate cellulitis. Photographic analysis showed that brow position and hairline contour were maintained in all cases.

Conclusions: The double-opposing rotation-advancement flap closure is a versatile reconstructive option for small, medium, and large forehead defects. The technique involves elevation of opposing, asymmetric flaps, with subsequent rotation of one side and advancement of the contralateral side. Single-stage closure may be accomplished without unappealing changes to the brow position or hairline.

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双反旋转推进皮瓣关闭额头缺陷。
目的:介绍一种不改变眉部位置和发际线的局部皮瓣,用于闭合各种大小的前额缺损。方法:回顾性分析应用双对向旋转推进皮瓣修复额部小缺损(20cm2) 16例的临床资料。这项技术是由Orticochea的方法发展而来的,用于缝合大面积的头皮伤口。结果:所有16例患者均采用我们的设计进行了一期前额缺损闭合。男性6例,女性8例(平均年龄71岁)。术前缺损大小为3 ~ 30 cm2(平均18 cm2)。所有伤口均为皮肤恶性肿瘤莫氏手术所致;其中2座与之前重建的建筑相邻。研究期间未见肿瘤复发。未发生永久性额支损伤。一名患者出现中度蜂窝织炎。照片分析显示,所有病例的眉毛位置和发际线轮廓保持不变。结论:双对向旋转推进皮瓣是一种修复小、中、大额头缺损的通用方法。该技术包括抬高相对的、不对称的皮瓣,随后旋转一侧和向前推进对侧。单阶段闭合可以在不改变眉毛位置或发际线的情况下完成。
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