皮下蒂皮瓣在面部腫瘤切除術后創面修復中的應用_West China Medical Journal

Authors：

 李正勇 , 岑瑛 ,  陳俊杰 , 蒲怡 , 伍俊良

四川大學華西醫院燒傷整形科, 成都 610041;

Corresponding?author：

李正勇, Email: lizydd@sina.com; 陳俊杰, Email: cjjemail@163.com

Keywords：

面部; 皮膚腫瘤; 皮下蒂皮瓣; 修復

DOI：

10.7507/1002-0179.201600293

Video：

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目的探討采用皮下蒂皮瓣修復面部腫瘤切除術后創面的臨床經驗。方法回顧性分析 2008 年1 月-2013 年 1 月收治的 60 例面部皮膚腫瘤患者，其中脂溢性角化癥 12 例，角化棘皮瘤 6 例，色素痣 10 例，基底細胞癌 30 例，鱗狀細胞癌 2 例。切除術后創面面積最小者為 0.5 cm×0.5 cm，位于右鼻翼，為色素痣切除術后創面；最大者為 6 cm×5 cm，位于鼻背部，為基底細胞癌切除術后創面。采用皮下蒂皮瓣修復面部皮膚腫瘤切除術后創面。結果 60 例患者均順利完成手術，術中出血少。術后未發生感染。除 1 例患者術后皮瓣遠端輕度缺血，形成薄痂，術后 10 d 痂殼脫落后傷口愈合，其余患者的傷口均獲一期愈合。術后隨訪 3 個月～5 年，無腫瘤復發，皮瓣形態良好，無明顯瘢痕。結論徹底切除、及時修復、獲得良好外觀是面部腫瘤切除術后創面修復的關鍵。由于面部血循環豐富，皮下蒂皮瓣為面部腫瘤切除術后創面修復的首選。

Citation： 李正勇, 岑瑛, 陳俊杰, 蒲怡, 伍俊良. 皮下蒂皮瓣在面部腫瘤切除術后創面修復中的應用. West China Medical Journal, 2016, 31(6): 1089-1091. doi: 10.7507/1002-0179.201600293 Copy

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8.	吳燕梅, 朱華鋒, 王健. 局部皮瓣在面部整形修復中的應用[J]. 中華全科醫學, 2009, 7(11) :1214-1215, 封3.
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11.	Orki? ?, Puntari? D, Vidosavljevi? D, et al. Climatic factors and epidemiologic characteristics of head and neck skin malignancies in osijek baranja county, Croatia[J]. Cent Eur J Public Health, 2015, 23(4) :275-285.
12.	Kraljik N, Rosso M, Ageel A, et al. The incidence of skin squamous cell carcinoma in Osijek-Baranja County——an epidemiological study[J]. Coll Antropol, 2011, 35(Suppl 2) :77-80.
13.	Goldberg DP. Assessment and surgical treatment of basal cell skin cancer[J]. Clin Plast Surg, 1997, 24(4) :673-686.
14.	Bailey IS, Goldwasser MS. Surgical management of facial skin cancer[J]. Oral Maxillofac Surg Clin N Am, 2005, 17(2) :205-233.
15.	Prstojevich SJ, Nierzwicki BL. Treatment options for premalignant and malignant cutaneous tumors[J]. Oral Maxillofac Surg Clin North Am, 2005, 17(2) :147-160.

1. Koplin L, Zarem HA. Recurrent basal cell carcinoma. A review concerning the incidence, behavior, and management of recurrent basal cell carcinoma, with emphasis on the incompletely excised lesion[J]. Plast Reconstr Surg, 1980, 65(5) :656-664.
2. Fattah A, Pollock J, Maheshwar A, et al. Big bad BCCs:craniofacial resection and reconstruction for atypical basal cell carcinomata[J]. J Plast Reconstr Aesthet Surg, 2010, 63(5) :e433-e441.
3. Manstein CH, Manstein ME, Beidas OE. Giant basal cell carcinoma:11-year follow-up and seven new cases[J]. Plast Reconstr Surg, 2011, 128(3) :1105-1106.
4. Hoban PR, Ramachandran S, Strange RC. Environment, phenotype and genetics:risk factors associated with BCC of the skin[J]. Expert Rev Anticancer Ther, 2002, 2(5) :570-579.
5. Ramachandran S, Fryer AA, Smith AG, et al. Basal cell carcinoma[J]. Cancer, 2000, 89(5) :1012-1018.
6. 李華, 邵雁, 葉學紅, 等. 隨意微小皮瓣在顏面部缺損的合理應用[J]. 中華整形外科雜志, 2005, 21(5) :391-392.
7. 嚴明忠, 鐘廣斌. 面部整形中局部皮瓣的應用[J]. 臨床醫學美容雜志, 1999, 5(1) :14-15.
8. 吳燕梅, 朱華鋒, 王健. 局部皮瓣在面部整形修復中的應用[J]. 中華全科醫學, 2009, 7(11) :1214-1215, 封3.
9. Baker SR. Regional flaps in facial reconstruction[J]. Otolaryngol Clin North Am, 1990, 23(5) :925-946.
10. Orki? ?, Puntari? D, Puntari? E, et al. Characteristics and incidence of head and neck skin malignant neoplasms in the population of the osijek-baranya county 2004-2012[J]. Acta Med Croatica, 2015, 69(1) :15-24.
11. Orki? ?, Puntari? D, Vidosavljevi? D, et al. Climatic factors and epidemiologic characteristics of head and neck skin malignancies in osijek baranja county, Croatia[J]. Cent Eur J Public Health, 2015, 23(4) :275-285.
12. Kraljik N, Rosso M, Ageel A, et al. The incidence of skin squamous cell carcinoma in Osijek-Baranja County——an epidemiological study[J]. Coll Antropol, 2011, 35(Suppl 2) :77-80.
13. Goldberg DP. Assessment and surgical treatment of basal cell skin cancer[J]. Clin Plast Surg, 1997, 24(4) :673-686.
14. Bailey IS, Goldwasser MS. Surgical management of facial skin cancer[J]. Oral Maxillofac Surg Clin N Am, 2005, 17(2) :205-233.
15. Prstojevich SJ, Nierzwicki BL. Treatment options for premalignant and malignant cutaneous tumors[J]. Oral Maxillofac Surg Clin North Am, 2005, 17(2) :147-160.

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