Zikmund L
Cesk Slov Oftalmol. 2016 Fall;72(3):72-79.
In the contemporary medicine, strong emphasis is put on early closing of body surface defects, which contributes to good and early healing, but, of course, closes the entrance gate for possible infection as well. The easiest closing of the defect is the direct suture of the emerged wound. But some defects are of such an extent, so their closure is necessary to handle other way than simple suture, e.g. by rotating flap plastic surgery. In the paper are evaluated results of flap surgery technique in 56 patients.
It is a retrospective overview of 56 patients operated on by the author in the years 2011-2012, in whom the rotating flap plastic surgery was used as surgery technique. In 46 patients, the reason of flap plastic surgery technique was tumor of the eyelids. In 35 patients, it was due to the basalioma of the lower eyelid, in 8 patients due to the basalioma of the upper eyelid, and in three patients due to the basalioma of the medial cantus region. In 10 patients, the reason of the surgery was ectropion of the lower eyelid, and in two of them bilaterally. The paper is supplemented by surgical procedures photographs, and by a table, with detailed analysis of the sizes of tumors and corresponding flaps as well.
According to the experience with 56 rotating flap plastic surgeries, performed by author during the period of two years at the Department of Ophthalmology, Masaryk Hospital in Ústí nad Labem, Czech Republic. E.U., the results of the use of rotating skin flaps in 46 eyelids basalioma, of correcting 12 ectropions of the lower eyelid, and reliability of the tumors excision with 2 mm surrounding healthy tissue rim were followed-up. Using the mentioned surgery technique, it was possible in all patients to secure the closing of the eyelid defect, or to return to normal and correct anatomical position of the eyelids in ectropions. In two patients with basalioma of the lower eyelid, the additional technique of lateral cantotomy was used to relieve the tension in the wound. Statistical results of recurrences number in tumors excisions with 2 mm safety margin in to the healthy tissue confirm the relative safety of such wide excision, and our results (4.34 %) differ only slightly from the results published in the literature (4.0 %).
flap plastic surgery, basalioma, ectropion.
在当代医学中,十分强调早期闭合体表缺损,这有助于伤口良好且早期愈合,但当然也会封闭可能发生感染的入口。最容易的缺损闭合方式是对出现的伤口进行直接缝合。但有些缺损范围较大,因此其闭合需要采用简单缝合以外的其他方式,例如通过旋转皮瓣整形手术。本文评估了56例患者的皮瓣手术技术效果。
这是对作者在2011 - 2012年期间为56例患者实施手术的回顾性综述,这些患者采用旋转皮瓣整形手术作为手术技术。46例患者中,皮瓣整形手术的原因是眼睑肿瘤。35例患者是由于下睑基底细胞瘤,8例患者是由于上睑基底细胞瘤,3例患者是由于内眦区域基底细胞瘤。10例患者手术的原因是下睑外翻,其中2例为双侧外翻。本文还补充了手术过程照片以及一个表格,对肿瘤大小和相应皮瓣进行了详细分析。
根据作者在捷克共和国乌斯季纳德拉贝姆市马萨里克医院眼科在两年期间实施的56例旋转皮瓣整形手术的经验。对46例眼睑基底细胞瘤使用旋转皮瓣、矫正12例下睑外翻以及在切除肿瘤时保留2毫米周边健康组织边缘的可靠性进行了随访。采用上述手术技术,所有患者都能够确保闭合眼睑缺损,或使下睑外翻患者的眼睑恢复正常且正确的解剖位置。2例下睑基底细胞瘤患者采用了额外的外侧眦切开术以缓解伤口张力。对切除肿瘤时保留2毫米健康组织安全边缘的复发次数统计结果证实了这种广泛切除的相对安全性,我们的结果(4.34%)与文献报道的结果(4.0%)仅略有差异。
皮瓣整形手术;基底细胞瘤;睑外翻