Ransom Evan R, Jacono Andrew A
Divisions of Facial Plastic and Reconstructive Surgery, Departments of Otolaryngology–Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York 11021, USA.
Arch Facial Plast Surg. 2012 Sep-Oct;14(5):342-5. doi: 10.1001/archfacial.2012.7.
To describe a local flap for closure of forehead defects of all sizes that does not alter the brow position or hairline.
Retrospective review of 16 cases in which the double-opposing rotation-advancement flaps were used for closure of small (<10 cm2), medium (10-20 cm2), and large (>20 cm2) forehead defects. This technique was developed from Orticochea's method for closure of large scalp wounds.
All 16 patients underwent single-stage closure of forehead defects using our design. Six patients were men, 8 were women (mean age, 71 years). Preoperative defect sizes ranged from 3 to 30 cm2 (mean, 18 cm2). All wounds resulted from Mohs surgery for cutaneous malignant neoplasms; 2 were adjacent to previous reconstructions. No recurrence of tumor was seen during the study period. No permanent frontal branch injuries occurred. One patient developed a moderate cellulitis. Photographic analysis showed that brow position and hairline contour were maintained in all cases.
The double-opposing rotation-advancement flap closure is a versatile reconstructive option for small, medium, and large forehead defects. The technique involves elevation of opposing, asymmetric flaps, with subsequent rotation of one side and advancement of the contralateral side. Single-stage closure may be accomplished without unappealing changes to the brow position or hairline.
描述一种用于闭合各种大小前额缺损的局部皮瓣，该皮瓣不会改变眉位或发际线。
回顾性分析16例使用双相对旋转推进皮瓣闭合小（<10 cm2）、中（10 - 20 cm2）和大（>20 cm2）前额缺损的病例。该技术是从奥尔蒂乔亚闭合大型头皮伤口的方法发展而来的。
所有16例患者均采用我们设计的方法进行前额缺损的一期闭合。6例为男性，8例为女性（平均年龄71岁）。术前缺损面积为3至30 cm2（平均18 cm2）。所有伤口均源于皮肤恶性肿瘤的莫氏手术；2例与先前的重建相邻。研究期间未见肿瘤复发。未发生永久性额支损伤。1例患者发生中度蜂窝织炎。影像学分析显示所有病例的眉位和发际线轮廓均得以维持。
双相对旋转推进皮瓣闭合术是闭合小、中、大型前额缺损的一种通用重建方法。该技术包括掀起相对的不对称皮瓣，随后一侧旋转，对侧推进。一期闭合可在不改变眉位或发际线的情况下完成。
