In the Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China, Xiaoli Lou, MD, PhD, is Attending Physician; and Chunyu Xue, MD, PhD, is Director. Joseph A. Molnar, MD, PhD, FACS, is Professor of Plastic and Reconstructive Surgery and Regenerative Medicine; Medical Director, Wound Care and Hyperbaric Center; and Associate Director, Burn Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Hongda Bi, MD, PhD, is Associate Professor, Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Adv Skin Wound Care. 2020 Jul;33(7):383-388. doi: 10.1097/01.ASW.0000661800.39497.94.
Reconstruction of facial skin defects remains a clinical challenge. With aging, ptosis of tissue over fixed structures creates an important facial feature known as the tear trough. This study aimed to evaluate the efficacy and aesthetic outcome of a novel surgical technique that reproduced this facial feature while avoiding ectropion during midfacial skin defect repair.
Nineteen patients with midfacial skin defects received local flap reconstruction combined with an anchoring suture. The flap was designed in a unilateral pedicled V-Y pattern. When the flap was advanced to cover the defect, one or two sutures that connected the dermis of the flap with the infraorbital periosteum were made to reproduce the tear trough line.
Midfacial defects were successfully repaired with the V-Y flap in all 19 patients. No lower eyelid ectropion or conspicuous scars were noted in any of the patients. Further, the tear trough was successfully reconstructed in each patient. Facial symmetry was maintained with static positioning and animation.
The combination of local V-Y flap reconstruction with anchoring sutures to reproduce facial feature lines is an effective technique in midfacial skin defect repair.
面部皮肤缺损的重建仍然是一个临床挑战。随着年龄的增长，固定结构上方组织的下垂会形成一个重要的面部特征，即泪槽。本研究旨在评估一种新的手术技术的疗效和美学效果，该技术在修复中面部皮肤缺损时可复制该面部特征，同时避免下睑外翻。
19 名中面部皮肤缺损患者接受局部皮瓣重建联合锚固缝线。皮瓣设计为单侧带蒂 V-Y 形。当皮瓣推进以覆盖缺损时，可制作一到两条缝线，将皮瓣的真皮与眶下骨膜连接起来，以再现泪槽线。
19 例患者均成功地用 V-Y 皮瓣修复了中面部缺损。所有患者均未出现下睑外翻或明显的瘢痕。此外，每位患者的泪槽都成功地得到了重建。通过静态定位和动画，面部对称性得以维持。
局部 V-Y 皮瓣重建联合锚固缝线以再现面部特征线是修复中面部皮肤缺损的有效技术。
