面部皮肤癌中的双叶皮瓣：我们在 285 例病例中的经验。

The bilobed flap in skin cancer of the face: our experience on 285 cases.

机构信息

Department of Head and Neck, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

J Craniomaxillofac Surg. 2010 Sep;38(6):460-4. doi: 10.1016/j.jcms.2009.10.022. Epub 2009 Nov 24.

DOI:10.1016/j.jcms.2009.10.022

PMID:19939690

Abstract

BACKGROUND

This article describes how many of the defects caused by oncological surgery can be closed with an easily estended flap.

PATIENT AND METHOD

The Zitelli bilobed flap was used to treat 285 consecutive patients with basal cell carcinomas (BCCs) or squamous cell carcinomas (SCCs); 167 men (58.60%) and 118 women (41.40%) between 45 and 98 years of age. Histologically, 247 BCCs (86.6%) and 38 SCCs (13.4%) were documented. Regarding the site, 148 (51.9%) involved the nose, 51 (17.9%) the cheeks, 36 (12.6%) the preauricular region, 27 (9.5%) the perilabial region and chin and 23 (8.1%) the periorbital region. To measure long-term satisfaction patients responded to a telephone survey consisting of a single global question.

RESULTS

The size of the defect following tumour removal was between 1 and 4cm. Carcinomas up to 1cm were treated using a one step procedure with a cryostat test of the surgical margins; all others cases were treated using two step procedure after excision and histological in sano resection. Completely acceptable aesthetic and functional deficits were obtained in 275 (96.4%) patients over a 6-72-month follow-up. Ten (3.6%) patients suffered postoperative complications. Two cases of local infection; one case of completely flap necrosis and seven cases of partial revision due to flap necrosis occurred. The level of satisfaction with the surgical long-term result reported by the patients was high.

CONCLUSION

In our experience the bilobed Zitelli flap for covering defects in the area of the face showed very few complications and good aesthetic results.

摘要

背景

本文描述了多少肿瘤外科手术引起的缺陷可以用易于扩展的皮瓣来闭合。

患者和方法

我们使用 Zitelli 双叶皮瓣治疗了 285 例连续的基底细胞癌（BCC）或鳞状细胞癌（SCC）患者；男性 167 例（58.60%），女性 118 例（41.40%），年龄在 45 至 98 岁之间。组织学上，247 例为 BCC（86.6%），38 例为 SCC（13.4%）。就部位而言，148 例（51.9%）涉及鼻子，51 例（17.9%）涉及脸颊，36 例（12.6%）涉及耳前区，27 例（9.5%）涉及唇周和下巴，23 例（8.1%）涉及眶周区域。为了测量长期满意度，患者通过电话调查回答了一个包含单个全局问题的问题。

结果

肿瘤切除后缺损的大小在 1 至 4cm 之间。直径达 1cm 的癌瘤采用一步法治疗，即用冷冻切片检查手术边缘；所有其他病例均采用切除和组织学无肿瘤切除的两步法治疗。在 6 至 72 个月的随访中，275 例（96.4%）患者获得了完全可接受的美学和功能缺陷。10 例（3.6%）患者发生术后并发症。有 2 例局部感染；1 例完全皮瓣坏死，7 例因皮瓣坏死而部分修正。患者对手术长期结果的满意度较高。