Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio.
Dermatology Professionals, Inc., East Greenwich, Rhode Island.
Dermatol Surg. 2020 Oct;46(10):1279-1285. doi: 10.1097/DSS.0000000000002319.
Bilobed transposition flaps are versatile random pattern flaps used in nasal and extranasal reconstruction as they preserve free margins, access distal tissue reservoirs, and reliably repair dynamic defects.
We highlight the utility of extranasal bilobed flaps to encourage surgeons to consider these flaps for Mohs micrographic surgery defects.
A two-institution retrospective chart review of patients reconstructed using an extranasal bilobed flap after Mohs micrographic surgery was performed. A validated scar scale was applied to postoperative photographs. Statistical analyses of the patient and surgery characteristics including patient co-morbidities, anatomic distribution, flap dimensions, and postprocedural events, including revisions, were conducted.
Forty-eight patients were identified. Site-specific flap dimensions were obtained with the cheek/lower eyelid requiring greater tissue mobilization with a higher final to primary defect ratio when compared with other sites. Postoperative events (complications, erythema, flap fullness, dehiscence, infection, etc.) were minimal. No major complications were noted. Nine cases of flap fullness or swelling were identified. Neither flap fullness nor dehiscence compromised flap integrity or cosmetic outcome. Independent flap cosmetic outcome review was good using a validated photographic scar scale.
Bilobed transposition flaps are versatile repairs for extranasal reconstruction with a favorable safety and outcome profile.
双叶皮瓣是一种多用途的随意皮瓣，用于鼻内和鼻外重建，因为它们可以保留自由边缘、接近远端组织储备，并可靠地修复动态缺陷。
我们强调了鼻外双叶皮瓣的实用性，以鼓励外科医生考虑将这些皮瓣用于 Mohs 显微外科手术缺陷。
对两家机构的接受 Mohs 显微外科手术后使用鼻外双叶皮瓣重建的患者进行了回顾性图表分析。对术后照片应用了经过验证的疤痕量表。对患者和手术特征进行了统计学分析，包括患者合并症、解剖分布、皮瓣尺寸以及包括修订在内的术后事件。
确定了 48 名患者。与其他部位相比，颊/下眼睑部位需要更大的组织动员，最终与原始缺陷的比例更高。术后事件（并发症、红斑、皮瓣饱满、裂开、感染等）很少。没有发现重大并发症。有 9 例皮瓣饱满或肿胀。皮瓣饱满或裂开均未损害皮瓣的完整性或美容效果。使用经过验证的照片疤痕量表对独立皮瓣的美容效果进行了良好的评估。
双叶皮瓣是一种多用途的鼻外重建修复方法，具有良好的安全性和效果。
