[颞浅动脉分叶穿支皮瓣修复颞肿瘤切除后皮肤软组织缺损的临床疗效]。

X S Liao, W Chen, H F Jiang, J Zhou, Z R Wei, S S Chang, F Zhang, K Y Nie
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引用次数: 0

摘要

目的:探讨颞浅动脉分叶穿支皮瓣修复颞部肿瘤切除后皮肤及软组织缺损的可行性和临床效果。方法:采用回顾性观察研究方法。2017年3月至2022年10月,遵义医科大学附属医院共收治颞部皮肤肿瘤患者10例,其中女性6例,男性4例,年龄42~87岁。其中3例为鳞状细胞癌,7例为基底细胞癌,病程6个月至5年。所有颞叶肿瘤均进行了扩大切除,切除后伤口面积为5.4 cm×4.2 cm至7.0 cm×4.0 cm。设计面积5.5cm×1.2cm~7.0cm×1.5cm的颞浅动脉额支皮瓣、面积4.2cm×3.5cm~5.0cm×4.0cm的颞深动脉降支皮瓣和面积4.2cm~1.0cm×5.0cm×1.0cm的颞顶浅动脉支皮瓣,修复创面,重建发际线。将皮瓣的供区闭合并直接缝合。在手术后3至5天观察皮瓣的存活,并且在手术后5至7天拆线时观察供体和受体部位的伤口愈合。术后随访中,在患侧颞区观察到颞区的出现、瘢痕增生、发际线重建和肿瘤复发。结果:术后3~5天皮瓣全部成活,术后5~7天供受部位创面全部愈合。在术后3-6个月的随访中,手术切口是隐蔽的;皮瓣没有肿胀,与周围皮肤颜色一致;无明显增生性瘢痕;患侧重建的发际线与健康侧没有显著差异;局部无肿瘤复发。结论:对于颞区大面积的皮肤和软组织缺损,颞浅动脉分叶穿支皮瓣可同时修复不同区域的伤口和缝合供区。手术操作简单,术后面部外观符合美观要求,局部无肿瘤复发,修复效果良好。这种方法特别适用于修复老年患者颞部大面积皮肤和软组织缺损。
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[Clinical effects of superficial temporal artery lobulated perforator flaps in repairing skin and soft tissue defects after temporal tumor resection].

Objective: To explore the feasibility and clinical effects of using superficial temporal artery lobulated perforator flaps in repairing skin and soft tissue defects after tumor resection in the temporal region. Methods: A retrospective observational study method was used. From March 2017 to October 2022, ten patients with temporal skin tumors were admitted to the Affiliated Hospital of Zunyi Medical University, including six women and four men, with age ranging from 42 to 87 years. Among them, three patients had squamous cell carcinoma and seven patients had basal cell carcinoma, with disease duration ranging from 6 months to 5 years. All temporal tumors underwent expanded resection, leaving wound areas of 5.4 cm×4.2 cm to 7.0 cm×4.0 cm after tumor resection. Superficial temporal artery frontal branch flaps with areas of 5.5 cm×1.2 cm to 7.0 cm×1.5 cm, superficial temporal artery descending branch flaps with areas of 4.2 cm×3.5 cm to 5.0 cm×4.0 cm, and superficial temporal artery parietal branch flaps with areas of 4.2 cm×1.0 cm to 5.0 cm×1.0 cm were designed to repair the wounds and reconstruct the hairline. The donor areas of the flaps were closed and sutured directly. The survival of the flaps was observed on 3 to 5 days after surgery, and the healing of wounds on the donor and recipient sites was observed when the stitches were removed on 5 to 7 days after surgery. During follow-up after surgery, the appearance of the temporal area, scar hyperplasia, hairline reconstruction, and tumor recurrence were observed in the temporal region on the affected side. Results: All the flaps survived well on 3 to 5 days after surgery, and all the donor and recipient site wounds healed well on 5 to 7 days after surgery. During follow-up of 3 to 6 months after surgery, the surgical incisions were concealed; the flaps were not swollen, with a consistent color to the surrounding skin; there were no obvious hypertrophic scars; the reconstructed hairline on the affected side was not significantly different from that of the healthy side; there was no tumor recurrence in the local area. Conclusions: For large areas of skin and soft tissue defects in the temporal region, the use of superficial temporal artery lobulated perforator flaps can repair the wounds in different regions and suture the donor sites in the primary stage simultaneously. The surgical operation is simple, and the facial appearance conforms to the aesthetic requirement after surgery with no tumor recurrence in the local area but a good repair effect. This method is particularly suitable for repairing large areas of skin and soft tissue defects in the temporal region in elderly patients.

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期刊介绍: The Chinese Journal of Burns is the most authoritative one in academic circles of burn medicine in China. It adheres to the principle of combining theory with practice and integrating popularization with progress and reflects advancements in clinical and scientific research in the field of burn in China. The readers of the journal include burn and plastic clinicians, and researchers focusing on burn area. The burn refers to many correlative medicine including pathophysiology, pathology, immunology, microbiology, biochemistry, cell biology, molecular biology, and bioengineering, etc. Shock, infection, internal organ injury, electrolytes and acid-base, wound repair and reconstruction, rehabilitation, all of which are also the basic problems of surgery.
期刊最新文献
[A case of severe acute respiratory distress syndrome caused by inhalation injury]. [A randomized controlled trial on the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns]. [Anatomical study of the architecture of the cutaneous branch-chained blood vessels in the medial lower leg in adult]. [Clinical effect of free posterior interosseous artery perforator flap carrying superficial vein for reconstructing severe perioral scar hyperplasia and contracture]. [Clinical effects of different types of tissue flaps in repairing the wounds with steel plate exposure and infection after proximal tibial fracture surgery].
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