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重新审视加韦洛耳垂单阶段重建手术:血管基础、技术及临床应用。

Revisiting Gavello's procedure for single-stage reconstruction of the earlobe: The vascular basis, technique and clinical uses.

作者信息

Chattopadhyay Debarati, Gupta Souradip, Murmu Marang Buru, Guha Goutam, Gupta Sandipan

机构信息

Department of Plastic Surgery, Medical College Kolkata, West Bengal, India.

出版信息

Can J Plast Surg. 2012 Summer;20(2):e22-4.

Abstract

BACKGROUND

Deformities or loss of the earlobe may be congenital, or acquired due to trauma, bites, burns or tumour excision. A variety of single-stage and two-stage procedures have been described for earlobe reconstruction, of which Gavello's procedure was one of the earliest.

OBJECTIVE

To revisit Gavello's procedure with reference to the vascular supply of the flap, and discuss the relevance of the technique in current practice.

METHODS

The authors discuss the vascular basis of Gavello's flap, and describe the clinical application of the single-stage Gavello's procedure in diverse clinical situations, including congenital absence of earlobe, post-burn earlobe deformity and traumatic amputation of the earlobe.

RESULTS

Excellent cosmetic results have been achieved in all different clinical situations in the authors' experience, with preservation of earlobe shape and volume, good colour match and a well-concealed scar in the donor area.

DISCUSSION

Gavello's procedure is a simple, one-stage procedure that relies entirely on local tissue for earlobe reconstruction; the flap has a predictable vascular supply, skin grafting is not required and the procedure can be used for large defects. An intact donor area over the postauricular mastoid region is a prerequisite.

CONCLUSION

The simple, century-old Gavello's procedure is still of great value for reconstruction of earlobe defects of diverse etiology.

摘要

背景

耳垂畸形或缺失可能是先天性的,也可能是由于创伤、咬伤、烧伤或肿瘤切除所致。已经描述了多种一期和二期耳垂重建手术,其中加韦洛手术是最早的手术之一。

目的

参照皮瓣的血供情况重新审视加韦洛手术,并讨论该技术在当前临床实践中的相关性。

方法

作者讨论了加韦洛皮瓣的血管基础,并描述了一期加韦洛手术在多种临床情况下的临床应用,包括先天性耳垂缺失、烧伤后耳垂畸形和耳垂外伤性截肢。

结果

根据作者的经验,在所有不同的临床情况下均取得了出色的美容效果,耳垂形状和体积得以保留,颜色匹配良好,供区瘢痕隐蔽。

讨论

加韦洛手术是一种简单的一期手术,完全依靠局部组织进行耳垂重建;皮瓣血供可预测,无需植皮,该手术可用于修复较大的缺损。耳后乳突区有完整的供区是必要条件。

结论

简单的、已有百年历史的加韦洛手术对于重建各种病因导致的耳垂缺损仍具有重要价值。

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