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[采用唇动脉进行血管重建的面部再植术。病例报告]

[Face replantation using labial artery for revascularization. Case report].

作者信息

de la Parra-Márquez Miguel, Mondragón-González Sergio, López-Palazuelos Jaime, Naal-Mendoza Norberto, Rangel-Flores Jesús María

机构信息

Departamento de Cirugía Plástica y Microcirugía Unidad Médica de Alta Especialidad 21, Instituto Mexicano del Seguro Social. Monterrey, Nuevo León, México,

出版信息

Cir Cir. 2013 May-Jun;81(3):221-4.

Abstract

BACKGROUND

Restoration of the face function and cosmetic appearance after a traumatic complex wound is a challenge for the plastic surgeon. Worldwide, few cases have been reported about face replantation.

OBJECTIVE

To present the case of the first partial face replantation reported in the national bibliography, using the labial artery for revascularization.

CLINICAL CASE

On June 19th 2011, a 7 years old male presented to the emergency room of the Mexican Institute of Social Security at Monterrey, Mexico, 4 hours after a partial face amputation secondary to a dog bite. The amputated segment was composed of 75% of the upper lip, 33% of the lower lip, oral commissure and 75% of the left cheek. The labial coronary artery and vein were anastomosed with 11-0 nylon sutures and the miorraphy of the orbicularis oris, the depressor anguli oris and the depressor labii inferioris with 4-0 vycril sutures. Six months after the surgery, the functional and aesthetic outcomes were excellent with reestablishment of total labial continence and total recovery of articulation of words.

CONCLUSIONS

amputations of any facial component should be initially managed with replantation. The function and cosmetics are better than any other technique of reconstruction. The labial coronary artery is an excellent choice for revascularization up to 25% of the face (lips and cheek).

摘要

背景

修复创伤性复杂伤口后的面部功能和外观对整形外科医生来说是一项挑战。在全球范围内,面部再植的病例报道较少。

目的

介绍国内文献中首例部分面部再植病例,采用唇动脉进行血管重建。

临床病例

2011年6月19日,一名7岁男性在墨西哥蒙特雷的墨西哥社会保障研究所急诊室就诊,其因狗咬伤导致部分面部离断4小时。离断部分包括75%的上唇、33%的下唇、口角和75%的左脸颊。用11-0尼龙缝线吻合唇冠状动脉和静脉,用4-0薇乔缝线对口轮匝肌、降口角肌和降下唇肌进行显微缝合。术后6个月,功能和美学效果极佳,唇部完全恢复节制功能,言语发音完全恢复。

结论

任何面部成分的离断最初都应尝试进行再植。其功能和美容效果优于任何其他重建技术。唇冠状动脉是对面部25%(嘴唇和脸颊)进行血管重建的极佳选择。

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