Yao Yuanzhen, Tang Xiujun, Wang Dali, Wei Zairong, Wang Bo, Deng Chengliang, Zhang Ziyang, Jin Wenhu
Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P.R.China.
Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Feb 15;32(2):210-214. doi: 10.7507/1002-1892.201709126.
To explore the effectiveness of propeller facial artery perforator flap to repair the defect after resection of skin malignant tumor at upper lip.
Between July 2012 and January 2017, 17 cases with skin malignant tumor at upper lip underwent tumor resection and the remained defect was repaired with propeller facial artery perforator flap. Among the 17 patients, 3 were male and 14 were female, with an average age of 57 years (range, 35-82 years). There were 5 cases of squamous cell carcinoma and 12 cases of basal cell carcinoma. The disease duration ranged from 4 months to 11 years with an average of 20 months. The tumor size ranged from 1.4 cm×0.3 cm to 3.1 cm×1.4 cm. The extended resection of the tumor tissue was performed according to the characters of tumor. According to the location, size, and shape of the defect and the position of facial artery perforator explored with Doppler ultrasonography, the propeller facial artery perforator flap was designed to repair the defect and partial donor site. The flap size ranged from 5 cm×2 cm to 7 cm×3 cm. The length of the perforator pedicle was 0.5-1.0 cm with an average of 0.8 cm. The defect at donor site was directly closed.
Cyanosis occurred in 3 cases of the distal flap after operation, then healing after symptomatic treatment. The remaining flaps survived successfully and the wound healed by first intention. Primary healing was obtained in the donor site. All the patients were followed up 6-36 months with an average of 18 months. The shape of the patient's upper lip was good and the scar on the donor site was unconspicuous. There was no lip deformity, ala nasi deflection, facial tension, entilation dysfunction, or recurrence of tumor during follow-up. At last follow-up, the results of self-evaluation were very satisfactory in 13 cases and satisfactory in 4 cases.
Based on multiple advantages of good blood supply, large rotation range, aesthetic outcome, and slight injury of the donor site, propeller facial artery perforator flap is not only an optimal choice for repairing upper lip defect after resection of skin malignant tumors, but also can achieve good functional and cosmetic effectiveness.
探讨螺旋桨式面动脉穿支皮瓣修复上唇皮肤恶性肿瘤切除术后缺损的效果。
2012年7月至2017年1月，17例上唇皮肤恶性肿瘤患者行肿瘤切除，采用螺旋桨式面动脉穿支皮瓣修复残留缺损。17例患者中，男3例，女14例，平均年龄57岁（范围35 - 82岁）。鳞状细胞癌5例，基底细胞癌12例。病程4个月至11年，平均20个月。根据肿瘤特点行肿瘤组织扩大切除。根据缺损的位置、大小、形状以及用多普勒超声探测的面动脉穿支位置，设计螺旋桨式面动脉穿支皮瓣修复缺损及部分供区。皮瓣大小为5 cm×2 cm至7 cm×3 cm。穿支蒂长度为0.5 - 1.0 cm，平均0.8 cm。供区缺损直接缝合。
术后3例皮瓣远端出现青紫，经对症处理后愈合。其余皮瓣均顺利成活，创面一期愈合。供区一期愈合。所有患者随访6 - 36个月，平均18个月。患者上唇外形良好，供区瘢痕不明显。随访期间无唇部畸形、鼻翼偏斜、面部张力、通气功能障碍或肿瘤复发。末次随访时，自我评估结果为非常满意13例，满意4例。
螺旋桨式面动脉穿支皮瓣具有血供良好、旋转范围大、美观效果好、供区损伤小等多重优点，不仅是修复上唇皮肤恶性肿瘤切除术后缺损的最佳选择，而且能取得良好的功能和美容效果。
