Li Guangxue, Lin Zhiyu, Liu Yan, Wang Cai, Zang Huiran, Yang Kai
Department of Plastic and Reconstructive Surgery, Peking University People's Hospital, Beijing, 100044, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Nov 15;35(11):1463-1466. doi: 10.7507/1002-1892.202106066.
To explore the effectiveness and safety of Pacman flap for repair of eyelid and periocular soft tissue defects.
The clinical data of 12 patients who underwent repair of eyelid and periocular soft tissue defects with Pacman flap between April 2015 and September 2020 was retrospectively reviewed. There were 5 males and 7 females, aged from 18 to 87 years, with a median age of 63 years. The disease duration ranged from 6 months to 50 years, with a median time of 3 years. The defect was located on the lateral eyelid in 5 cases, inferior eyelid in 3 cases, inferior and medial eyelid in 2 cases, inferior and lateral eyelid in 2 cases, and lateral eyebrow in 1 case. Pathological diagnosis included 4 cases of basal cell carcinoma, 4 cases of squamous cell carcinoma, 1 case of junction nevus, 1 case of intradermal nevus, 1 case of seborrheic keratosis, and 1 case of keratoacanthoma. The size of defects ranged from 1.4 cm×1.2 cm to 5.5 cm×5.0 cm. According to the skin mobility and toughness around the defects, Pacman flaps with the size of 1.6 cm×1.4 cm to 10.0 cm×6.0 cm were designed and advanced to repair the defects.
All flaps survived completely with no necrosis. One patient had infection, and another patient had partial wound dehiscence, but the wounds healed after dressing change without further debridement. Other patients all recovered successfully. The follow-up time ranged from4 to 51 months, with a median time of 12 months. No recurrence and metastasis occurred, and the scars were invisible without deformity of eyelid and brow. All patients were satisfied with the aesthetic and functional outcomes of the eyes.
Pacman flap is a simple and feasible technique for repair of eyelid and periocular soft tissue defects, with satisfactory effectiveness.
探讨“吃豆人”皮瓣修复眼睑及眼周软组织缺损的有效性和安全性。
回顾性分析2015年4月至2020年9月间12例行“吃豆人”皮瓣修复眼睑及眼周软组织缺损患者的临床资料。其中男性5例，女性7例，年龄18～87岁，中位年龄63岁。病程6个月至50年，中位时间3年。缺损位于睑外侧5例，睑下3例，睑下及睑内侧2例，睑下及睑外侧2例，眉外侧1例。病理诊断包括基底细胞癌4例，鳞状细胞癌4例，交界痣1例，皮内痣1例，脂溢性角化病1例，角化棘皮瘤1例。缺损大小为1.4 cm×1.2 cm至5.5 cm×5.0 cm。根据缺损周围皮肤的活动度和韧性，设计大小为1.6 cm×1.4 cm至10.0 cm×6.0 cm的“吃豆人”皮瓣并推进修复缺损。
所有皮瓣均完全存活，无坏死。1例患者发生感染，另1例患者伤口部分裂开，但换药后伤口愈合，无需进一步清创。其他患者均成功康复。随访时间4至51个月，中位时间12个月。无复发及转移，瘢痕不可见，眼睑及眉无畸形。所有患者对眼部的美学和功能效果均满意。
“吃豆人”皮瓣是修复眼睑及眼周软组织缺损的一种简单可行的技术，效果满意。
