Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Feldkirch, Austria.
Aesthetic Plast Surg. 2011 Aug;35(4):475-9. doi: 10.1007/s00266-010-9639-y. Epub 2010 Dec 24.
Defect closure on the nasal tip subunit still remains challenging. Full-thickness skin transplantation still is used despite its poor outcome in terms of the nasal tip contour caused by lack of dermal tissue. To avoid subsidence deformities associated with nasal tip reconstruction with skin transplants, this study analyzed methods using combined epidermal and dermal replacement. For 30 consecutive patients with a nasal tip defect, a retrospective comparison was made between conventional full-thickness skin transplantation, retroauricular perichondrodermal composite grafts, and skin transplantation supplemented with the collagen-elastin matrix, Matriderm, used as a dermal substitute (n = 10 per study group).The postoperative results were evaluated in a randomized and blind manner by external facial surgeons using the Manchester Scar Scale. The findings showed a marked improvement in nasal tip contour with combined epidermal/dermal replacement without any deterioration in other graft qualities, justifying the additional effort involved in this procedure. Two patients developed fistulae after Matriderm-aided skin transplantation. Therefore, the authors do not consider this a suitable method for nasal tip reconstruction.
鼻尖亚单位的缺损闭合仍然具有挑战性。尽管全厚皮片移植在鼻尖轮廓方面的效果不佳，因为其缺乏真皮组织，但仍在使用。为了避免因使用皮片移植进行鼻尖重建而导致的凹陷畸形，本研究分析了使用联合表皮和真皮替代物的方法。对 30 例连续的鼻尖缺损患者，对常规全厚皮片移植、耳后软骨膜复合移植物和皮片移植联合胶原-弹性蛋白基质（Matriderm）作为真皮替代物（每组各 10 例）进行了回顾性比较。外部面部外科医生采用曼彻斯特瘢痕量表以随机和盲法的方式对术后结果进行评估。研究结果表明，联合表皮/真皮替代物可显著改善鼻尖轮廓，而其他移植物质量没有恶化，这证明了该手术的额外努力是合理的。两名患者在接受 Matriderm 辅助皮片移植后出现了瘘管。因此，作者认为这不是一种适合鼻尖重建的方法。
