Meyers S, Rohrer T, Grande D
Department of Dermatology, Boston University School of Medicine, Boston, MA, USA.
Dermatol Surg. 2001 Mar;27(3):300-5.
Deep postsurgical defects on the nose and alar rim pose a challenge to repair. Several techniques are available to reestablish normal contour. If a depressed area is anticipated, dermal grafts can be used to fill the defect and soften contour irregularities. The technique is simple and can prevent the need for a more complicated repair.
To reestablish normal contour over nasal defects by using dermal grafts as a tissue filler in conjunction with graft and flap reconstruction.
Fifteen patients had contour deformities that could be improved with dermal graft insertion under their full-thickness skin grafts or flaps. Fourteen of these patients had nasal defects and one had a vermilion border defect that resulted from tumor removal by Mohs surgery. Patient selection, dermal graft harvesting, and surgical technique are described.
All patients showed cosmetic benefit from dermal grafting. Contour was improved in each case. Fourteen patients had no significant complications. One flap showed tip necrosis in a patient who was a smoker. No resorption of the dermal grafts occurred over the 1- to 9-month follow-up period. No cyst formation occurred.
Dermal grafts can be used during the initial repair of postsurgical nasal defects. These dermis grafts effectively fill the defect and restore contour. The technique is simple, easily mastered, and can obviate the need for more complicated repair.
鼻及鼻翼缘术后深度缺损的修复颇具挑战。有多种技术可用于重建正常外形。若预计存在凹陷区域，可使用真皮移植来填充缺损并软化外形不规则处。该技术操作简单，可避免更复杂的修复需求。
通过使用真皮移植作为组织填充物，结合移植和皮瓣重建，恢复鼻缺损处的正常外形。
15例患者存在轮廓畸形，可通过在全厚皮片或皮瓣下插入真皮移植来改善。其中14例患者有鼻缺损，1例患者因Mohs手术切除肿瘤导致唇红缘缺损。描述了患者选择、真皮移植获取及手术技术。
所有患者均从真皮移植中获得了美容效果。每例患者的外形均得到改善。14例患者无明显并发症。1例吸烟者的皮瓣出现尖端坏死。在1至9个月的随访期内，真皮移植未发生吸收。未形成囊肿。
真皮移植可用于术后鼻缺损的初期修复。这些真皮移植能有效填充缺损并恢复外形。该技术操作简单，易于掌握，可避免更复杂的修复需求。
