Li Zhuo-Ran, Jiang Yong, Zhang Jun-Yan, Su Yun-Wei, Hu Jian-Zhong
Department of Dermatology, Tianjin Medical University Second Hospital Tianjin 300211, China.
Department of Dermatology, Tianjin Medical University General Hospital Tianjin 300052, China.
Int J Clin Exp Pathol. 2017 Sep 1;10(9):9158-9163. eCollection 2017.
Round or oval defects are common in skin surgery. Functional and cosmetical reconstruction of defects in reparative process is critical for patients. Various flaps have been described, however, these flaps often result in longer scar or tip necrosis. To overcome these shortcomings, we modified O-T advancement flap on the basis of conventional O-T flap and observed the validity and complications during defect closure.
Defect transverse diameter was marked along the direction of minimum tension at the circular center. Extended line was drawn along defect transverse diameter with the same length of circular diameter. The skin was cut apart, and the flap was separated under the skin. Then the flap tips were sutured and fixed with the opposite center. After drainage, the defects were bandaged under compression.
This study includes a total number of 48 patients. We examined the location and size of defect and postoperative clinical courses. The follow-up period was from 3 months to 1 year. Overall, 41 of 48 patients achieved the satisfactory postoperative effect. Recurrence and limb dysfunction complication was not observed, except 2 cases of wound scar, 3 cases of wound infect and 2 cases of flap tip necrosis.
Modified O-T advancement flap is practical and safety. It overcomes the shortcomings of traditional O-T flap. Reconstruction of modified O-T flap is aesthetically acceptable.
圆形或椭圆形缺损在皮肤外科手术中很常见。缺损修复过程中的功能和美容重建对患者至关重要。已经描述了各种皮瓣,然而,这些皮瓣常常导致更长的瘢痕或皮瓣尖端坏死。为了克服这些缺点,我们在传统O-T皮瓣的基础上改良了O-T推进皮瓣,并观察了缺损闭合过程中的有效性和并发症。
沿圆形中心最小张力方向标记缺损横径。沿缺损横径绘制延长线,其长度与圆形直径相同。切开皮肤,在皮下分离皮瓣。然后将皮瓣尖端缝合并固定到相对的中心。引流后,对缺损进行加压包扎。
本研究共纳入48例患者。我们检查了缺损的位置和大小以及术后临床病程。随访期为3个月至1年。总体而言,48例患者中有41例术后效果满意。除2例伤口瘢痕、3例伤口感染和2例皮瓣尖端坏死外,未观察到复发和肢体功能障碍并发症。
改良O-T推进皮瓣实用且安全。它克服了传统O-T皮瓣的缺点。改良O-T皮瓣的重建在美学上是可以接受的。