Liu Yuan-Bo, Fan Jin-Cai, Jiao Peng, Tang Xin, Liu Li-Qiang, Wang Qian, Tian Jia, Gan Cheng, Yang Zeng-Jie, Zhang Zhuo-Nan, Chen Yu-Gang
Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100041, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2007 May;23(3):187-90.
To provide an ideal method for flap prefabrication.
The superficial temporal fascial flap has been elevated based on the superficial temporal vessels during the first-stage procedure. A subcutaneous tissue pocket with appropriate site was formed in the retroauricular and mastoid process region. The fascial flap was transferred into the pocket and fixed properly. The tissue expander was placed under the fascial flap. When the expanding process has been finished, the expander was removed and the expanded induced prefabricated skin flap of the retroauricular and mastoid process region pedicled on the superficial temporal vascular bundle was elevated and transferred to repair the facial skin defect.
There were nine cases in the group. Facial defects after resection of the melanotic nevus was repaired in 2 cases and facial defects after resection of the facial haemangioma and scar were repaired in 2 and 5 cases respectively. Pedicle length of the superficial temporal fascial flap was ranged from 5.5 cm to 7 cm (mean length 6.2 cm). The size of the fascial flaps was ranged from 4 cm x 3 cm to 7 cm x 7 cm (mean size 5.7 cm x 4.9 cm). The size of the prefabricated skin flaps was ranged from 5 cm x 5 cm to 8.0 cm x 7.5 cm (mean size 6.4 cm x 6.1 cm). The average time of the tissue expansion process is 16.1 weeks. All flaps survived postoperatively and the donor sites of the flaps were appropriated directly in 5 cases. The split-thickness skin grafting was used to recover the donor site defects in 4 cases.
The superficial temporal fascial flap owns the following advantages: the vascular pedicle is much longer and vascular supply is plentiful, and it is convenient to transfer. Meanwhile, the skin of the retroauricular and mastoid process region is most similar to that of the face in texture, color and depth. For the patients selected strictly, the technique mentioned above is somewhat an ideal method for facial defect repair.
提供一种理想的皮瓣预制方法。
一期手术时基于颞浅血管掀起颞浅筋膜瓣。在耳后及乳突区形成合适部位的皮下组织腔隙。将筋膜瓣转移至腔隙并妥善固定。在筋膜瓣下放置组织扩张器。扩张过程完成后，取出扩张器，掀起以颞浅血管束为蒂的耳后及乳突区扩张诱导预制皮瓣并转移修复面部皮肤缺损。
该组共9例。其中2例修复黑素痣切除后的面部缺损，2例和5例分别修复面部血管瘤及瘢痕切除后的面部缺损。颞浅筋膜瓣蒂长5.5 cm至7 cm（平均长度6.2 cm）。筋膜瓣大小为4 cm×3 cm至7 cm×7 cm（平均大小5.7 cm×4.9 cm）。预制皮瓣大小为5 cm×5 cm至8.0 cm×7.5 cm（平均大小6.4 cm×6.1 cm）。组织扩张平均时间为16.1周。术后所有皮瓣均存活，5例皮瓣供区直接拉拢缝合，4例采用中厚皮片移植修复供区缺损。
颞浅筋膜瓣具有以下优点：血管蒂较长，血供丰富，转移方便。同时，耳后及乳突区皮肤在质地、颜色和厚度上与面部最为相似。对于严格筛选的患者，上述技术是一种较为理想的面部缺损修复方法。
