Dunkley M P, Stevenson J H
Department of Plastic Surgery, Dundee Royal Infirmary.
Br J Plast Surg. 1990 Mar;43(2):154-8. doi: 10.1016/0007-1226(90)90154-r.
Reconstruction of the soft tissue facial contour defect in Romberg's disease and facial lipodystrophy using a free groin flap has been previously reported. However, controversy exists over the optimum placing of this flap within the cheek, i.e. whether it is better to have the dermis or subcutaneous fat side next to the muscle. Our experience with 6 flaps, 3 of which have been followed up for 3 1/2 years, is presented. In all cases the flaps were placed with the dermis side down, i.e. next to muscle. Although not a comparative study, our impression is that in the long term this technique reduces gravitational migration. Our experience with 2 flaps suggests that, in the early postoperative period at least, secure fixation by suturing to the muscle and periosteum is important. We believe that, in addition, this method gives a smoother contour and allows easy and safe secondary adjustments to be made where necessary.
此前已有报道使用游离腹股沟皮瓣修复Romberg病和面部脂肪营养不良导致的面部软组织轮廓缺损。然而，关于该皮瓣在脸颊内的最佳放置位置存在争议，即真皮层或皮下脂肪层靠近肌肉哪一侧更好。本文介绍了我们使用6个皮瓣的经验，其中3个已随访3年半。所有病例中皮瓣均将真皮层朝下放置，即靠近肌肉。虽然不是对比研究，但我们的印象是，从长远来看，这种技术可减少重力性移位。我们使用2个皮瓣的经验表明，至少在术后早期，通过缝合固定于肌肉和骨膜是很重要的。我们还认为，这种方法能提供更平滑的轮廓，并在必要时便于进行简单安全的二次调整。
