Brunetti Beniamino, Tenna Stefania, Poccia Igor, Segreto Francesco, Persichetti Paolo
From the Unit of Plastic Surgery and Dermatology, "Campus Bio-Medico di Roma" University, Rome, Italy.
Ann Plast Surg. 2017 Jul;79(1):34-38. doi: 10.1097/SAP.0000000000001022.
A-T plasty has long been a workhorse for defects located around the eyebrow or in the upper and lower lip. It allows like-with-like reconstruction with placement of the scars in natural creases or subunit junctions. In this article, the authors describe their refined technique to specifically address moderate to large size defects of the frontotemporal, preauricular, and zygomatic regions.
Thirty consecutive patients underwent reconstruction with the extended A-T plasty at our institution after skin cancer excision. Mean age at surgery was 63 years (range, 39-87 years). Mean defect size was 5.2 × 4.7 cm. The defects were located in the frontotemporal (13), upper preauricular (10), and zygomatic (7) facial subunits.
Mean operative time was 65 minutes. Three (10%) patients suffered from delayed healing at the T junction, with no impairment in the long-term follow-up. All the other flaps healed uneventfully with optimal long-term cosmetic and functional restoration. Follow-up ranged from 3 months to 3 years (mean, 19 months).
The basic principles of the A-T plasty were applied to design large advancement-rotation flaps incorporating frontotemporal and preauricular cervicofacial skin. The resulting extended A-T plasty proved to be a simple, reliable, and reproducible technique to resurface, in a "like with like" fashion, moderate to large defects located in the frontotemporal, preauricular and zygomatic facial subunits.
A - T皮瓣成形术长期以来一直是修复眉周或上下唇周围缺损的常用方法。它能够实现类似组织的重建，使瘢痕位于自然皱纹或亚单位交界处。在本文中，作者描述了他们改良的技术，专门用于修复额颞部、耳前和颧部的中度至大面积缺损。
30例连续患者在我院接受皮肤癌切除术后采用改良A - T皮瓣成形术进行修复。手术时的平均年龄为63岁（范围39 - 87岁）。平均缺损大小为5.2×4.7厘米。缺损位于额颞部（13例）、耳前上部（10例）和颧部（7例）面部亚单位。
平均手术时间为65分钟。3例（10%）患者在T形交界处愈合延迟，但在长期随访中无功能障碍。所有其他皮瓣均顺利愈合，长期美容和功能恢复良好。随访时间为3个月至3年（平均19个月）。
A - T皮瓣成形术的基本原则被应用于设计包含额颞部和耳前颈面部皮肤的大型推进旋转皮瓣。改良后的A - T皮瓣成形术被证明是一种简单、可靠且可重复的技术，能够以“类似组织修复”的方式修复额颞部、耳前和颧部面部亚单位的中度至大面积缺损。
