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莫氏显微外科手术后的耳廓重建:101例分析。

Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases.

作者信息

Bittner Guilherme Canho, Kubo Elisa Mayumi, Fantini Bruno de Carvalho, Cerci Felipe Bochnia

机构信息

Dermatology Service, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil; Private Practice, Campo Grande, MS, Brazil.

Private Practice, Porto União, PR, Brazil.

出版信息

An Bras Dermatol. 2021 Jul-Aug;96(4):408-415. doi: 10.1016/j.abd.2020.12.008. Epub 2021 Jun 3.

DOI:10.1016/j.abd.2020.12.008
PMID:34090728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8245722/
Abstract

BACKGROUND

The ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact.

OBJECTIVE

To describe the authors' experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods.

METHODS

Retrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years.

RESULTS

One hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection).

STUDY LIMITATIONS

Retrospective design and the absence of long-term follow-up of some cases.

CONCLUSIONS

The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.

摘要

背景

耳部是皮肤癌高发区域,多项指南表明莫氏显微外科手术是此类病例的首选治疗方法。尽管该技术能最大程度保留健康组织,但由于耳部特殊的局部解剖结构,存在明显的曲线和起伏,许多耳部手术伤口的处理颇具挑战。耳部重建应在注重功能的同时兼顾美观,因为术后畸形可能会产生重大的心理影响。

目的

描述作者在莫氏手术后进行耳部重建的经验,并评估最常用的修复方法。

方法

对连续3年接受莫氏手术及耳部重建的病例进行回顾性研究。

结果

共纳入101例病例,最常见的修复方法是一期缝合(n = 35),其次是全厚皮片移植(n = 30)和皮瓣(n = 24)。30例采用了联合重建方法。7例患者出现并发症(部分移植皮片坏死、术后出血或感染)。

研究局限性

回顾性设计且部分病例缺乏长期随访。

结论

皮肤科医生应熟悉耳部重建的不同选择。一期缝合和皮片移植是最常用的修复方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/85feb3bedc53/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/59b175dde129/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/10aad5b473ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/099101d664f6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/2c7951b96a80/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/8248e28dcedb/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/5e923a5396b0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/b60538606bec/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/85feb3bedc53/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/59b175dde129/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/10aad5b473ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/099101d664f6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/2c7951b96a80/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/8248e28dcedb/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/5e923a5396b0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/b60538606bec/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd8/8245722/85feb3bedc53/gr8.jpg

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Reconstruction of the Ear.耳部重建
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