Xu Xinjiang, Tang Mingming, Han Liang, Jiang Bin
Department of Head and Neck Surgery,Cancer Hospital Affiliated to Nantong University,Nantong,226361,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jan 5;35(1):44-48. doi: 10.13201/j.issn.2096-7993.2021.01.011.
To investigate the clinical effect of modified V-Y advancement flap for reconstruction of facial skin defect. Thirty-eight patients with facial skin tumors underwent individual tumor resection according to pathological type and lesion depth. Based on the defect site and size, appropriate V-Y advancement flap was designed to reconstruct the skin defect in one stage. There were 9 cases of classic subcutaneous tissue pedicle V-Y advancement flap, 24 cases of modified subcutaneous tissue pedicle V-Y advancement flap and 5 cases of perforated V-Y advancement flap in our study. Among the 38 patients, 34 cases had primary healing. Two cases developed necrosis at the edge of the flap and healed after debridement. Local infection occurred in 2 cases, which healed after short-term dressing change. Postoperative mild eyelid ectropion occurred in 2 cases and oral horn displacement in 1 case. The patients were followed up for 6-36 months postoperatively, and the function and appearance recovered well. One case had local recurrence and 3 cases had parotid lymph node metastasis, which were removed again and supplemented with radiotherapy. The improved design of V-Y advancement flap can enlarge the scope of facial defect reconstruction, and achieve good appearance and function.
探讨改良V-Y推进皮瓣修复面部皮肤缺损的临床效果。38例面部皮肤肿瘤患者根据病理类型及病变深度行个体化肿瘤切除。根据缺损部位及大小,设计合适的V-Y推进皮瓣一期修复皮肤缺损。本研究中经典皮下组织蒂V-Y推进皮瓣9例,改良皮下组织蒂V-Y推进皮瓣24例,穿支V-Y推进皮瓣5例。38例患者中,34例一期愈合。2例皮瓣边缘出现坏死,清创后愈合。2例发生局部感染,经短期换药后愈合。术后2例出现轻度睑外翻,1例口角移位。术后随访6~36个月,功能及外形恢复良好。1例局部复发,3例发生腮腺淋巴结转移,再次手术切除并辅以放疗。改良V-Y推进皮瓣设计可扩大面部缺损修复范围,获得良好的外形及功能。