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再探皮下颈面部皮瓣

The subcutaneous cervicofacial flap revisited.

作者信息

Austen William G, Parrett Brian M, Taghinia Amir, Wolfort Sean F, Upton Joseph

机构信息

Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Ann Plast Surg. 2009 Feb;62(2):149-53. doi: 10.1097/SAP.0b013e31819354f5.

Abstract

The cervicofacial flap has been the reconstruction of choice for midface soft tissue defects for over 30 years. Deep plane dissection has been advocated to decrease complication rates and improve results. However, the subcutaneous approach is still widely used. Over a 20-year period, we reviewed all patients who underwent subcutaneous cervicofacial flaps for cheek defects to analyze complications and results.Thirty-two patients (mean age, 71 years) underwent 32 subcutaneous cervicofacial flaps for cheek reconstruction after Mohs micrographic excision of skin cancer. The mean defect size was 7.2 x 5.8 cm. Mean follow-up was 32 months. Only 3 of 32 patients (9%) had minor flap tip or edge necrosis, all managed without further surgery. One patient (3%) had minor long-term ectropion with upward gaze and 31 of 32 patients were happy with their results.The subcutaneous rotation-advancement cervicofacial flap remains an excellent choice for cheek reconstruction with comparable tip necrosis rates and likely lower ectropion rates when compared with the deep plane technique.

摘要

30多年来,颈面部皮瓣一直是修复面中部软组织缺损的首选方法。有人主张采用深层平面解剖以降低并发症发生率并改善效果。然而,皮下入路仍被广泛应用。在20年的时间里,我们回顾了所有接受皮下颈面部皮瓣修复面颊缺损的患者,以分析并发症和效果。32例患者(平均年龄71岁)在皮肤癌Mohs显微外科切除术后接受了32次皮下颈面部皮瓣修复面颊。平均缺损大小为7.2×5.8厘米。平均随访32个月。32例患者中只有3例(9%)出现轻微的皮瓣尖端或边缘坏死,均未进一步手术处理。1例患者(3%)出现轻微的长期上睑外翻伴向上凝视,32例患者中有31例对结果满意。与深层平面技术相比,皮下旋转推进颈面部皮瓣仍是修复面颊的绝佳选择,其尖端坏死率相当,且睑外翻率可能更低。

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