Griffin Garrett R, Weber Stephen, Baker Shan R
Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor, 48109, USA.
Arch Facial Plast Surg. 2012 May-Jun;14(3):193-7. doi: 10.1001/archfacial.2012.35.
To characterize revision surgery following V-Y subcutaneous tissue pedicle advancement flap repair of large upper lip skin defects.
Retrospective review of upper lip skin defects at least 3.0 cm(2) in area that were reconstructed with a V-Y subcutaneous tissue pedicle advancement flap at an academic tertiary care center. Depth and area of the defect, as well as involvement of the vermilion and nasal ala, were recorded as independent variables. Revision techniques were analyzed to identify patterns.
Thirty patients were identified as having upper lip skin defects with a mean (range) area of 7.0 (3.0-14.0) cm(2) (median, 6.25 cm(2)). The defect involved the nasal ala in 4 cases and the vermilion in 3 cases. At least 1 revision surgery was performed in 14 patients (47%). Alar or vermilion involvement was a significant factor in revision by χ(2) analysis (P = .03). Larger defect size did not predict a need for revision, even among cases where the defect did not involve the ala or vermilion (P = .68).
Reconstruction of large upper lip skin defects with a V-Y subcutaneous tissue pedicle advancement flap is associated with a 47% revision rate, and when the defect involves the ala or vermilion, the revision rate is increased. Defect size alone cannot be used to predict the need for revision surgery. Revision techniques are demonstrated.
对采用V-Y皮下组织蒂推进皮瓣修复上唇大面积皮肤缺损后的修复手术进行特征描述。
回顾性分析在一家学术性三级医疗中心采用V-Y皮下组织蒂推进皮瓣修复面积至少为3.0 cm²的上唇皮肤缺损情况。将缺损的深度和面积以及唇红缘和鼻翼的累及情况记录为独立变量。分析修复技术以确定模式。
确定30例患者存在上唇皮肤缺损，平均（范围）面积为7.0（3.0 - 14.0）cm²（中位数为6.25 cm²）。4例缺损累及鼻翼，3例累及唇红缘。14例患者（47%）至少进行了1次修复手术。通过χ²分析，鼻翼或唇红缘累及是修复的一个重要因素（P = .03）。即使在缺损未累及鼻翼或唇红缘的病例中，较大的缺损尺寸也不能预测是否需要修复（P = .68）。
采用V-Y皮下组织蒂推进皮瓣修复上唇大面积皮肤缺损的修复率为47%，当缺损累及鼻翼或唇红缘时，修复率会增加。仅缺损大小不能用于预测是否需要修复手术。展示了修复技术。
