Newlove Tracey, Trufant Joshua W, Cook Joel
*Tucson Dermatology Ltd., Tucson, Arizona; †Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; ‡Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
Dermatol Surg. 2016 Mar;42(3):320-6. doi: 10.1097/DSS.0000000000000641.
Single-stage repairs of large nasal dorsum defects risk introducing lower nasal distortion.
To describe the authors experience with the "birhombic" flap, a bilateral Dufourmentel rhomboid flap, for repair of nasal surgical defects after Mohs micrographic surgery.
The authors performed a retrospective chart review of patients who underwent birhombic flap repair of the nose by a single physician after Mohs micrographic surgery from 2008 to 2013 at the Medical University of South Carolina.
Thirty-eight patients were identified on whom the birhombic flap repair was performed on the nasal dorsum over a 6-year period. There were no significant complications. Alar position remained neutral and nasal profile remained unaltered in all cases. Postoperatively, pulsed dye laser was performed in 8 patients (21%) and dermabrasion in 11 patients (29%). All patients achieved very good or excellent final aesthetic results.
The birhombic flap is a reproducible, one-stage flap for small to large defects of the nasal dorsum that consistently produces topographic restoration with minimal risk of aesthetic or functional complication. The use of 2 opposing flaps redistributes the secondary defect, thus minimizing the potential for lower nasal distortion when closing the flaps' donor sites.
一期修复大的鼻背缺损有导致鼻下部变形的风险。
描述作者使用“双菱形”皮瓣（双侧杜福尔芒泰尔菱形皮瓣）修复莫氏显微外科手术后鼻手术缺损的经验。
作者对2008年至2013年在南卡罗来纳医科大学由同一位医生对接受莫氏显微外科手术后行双菱形皮瓣修复鼻部的患者进行了回顾性病历审查。
确定了38例在6年期间接受鼻背双菱形皮瓣修复的患者。无明显并发症。所有病例中鼻翼位置保持中立，鼻外形未改变。术后，8例患者（21%）接受了脉冲染料激光治疗，11例患者（29%）接受了磨皮治疗。所有患者最终均获得了非常好或优秀的美学效果。
双菱形皮瓣是一种可重复使用的一期皮瓣，用于修复鼻背从小到大面积的缺损，能始终实现外形修复，美学或功能并发症风险极小。使用两个相对的皮瓣可重新分布继发缺损，从而在关闭皮瓣供区时将鼻下部变形的可能性降至最低。
