Kitcat M, Benyon S L
Plastic and Reconstructive Surgery Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK.
JPRAS Open. 2022 May 12;33:32-36. doi: 10.1016/j.jpra.2022.05.001. eCollection 2022 Sep.
The choice between skin graft and local flap reconstruction depends upon the surgeon's experience and the facilities available. For skin cancers, our main objective is clear, oncologic clearance with preservation of function. For some patients, aesthetic outcome is often equally important. In our experience, majority of our trainees will often choose skin graft reconstruction as their primary choice of reconstruction due to the fact that there is a perceived idea that this is easier to perform than a local flap. However, for lower limb or head and neck reconstructions, skin graft may result in a significant contour defect which can potentially be avoided. We present a series of cases of an alternative flap, the trapezoid advancement, a very simple design that can be utilised in several areas of the body and technically very easily replicated. This technique allows for the advancement of tissue with a minimal tension closure as compared to other local flaps. Our results showed no flap loss and excellent cosmetic outcome.
植皮与局部皮瓣重建的选择取决于外科医生的经验和可用的设备。对于皮肤癌,我们的主要目标很明确,即清除肿瘤并保留功能。对一些患者来说,美学效果通常同样重要。根据我们的经验,我们的大多数实习生常常会选择植皮重建作为他们首选的重建方式,因为他们认为这比局部皮瓣更容易操作。然而,对于下肢或头颈部重建,植皮可能会导致明显的轮廓缺陷,而这一缺陷有可能避免。我们展示了一系列使用一种替代皮瓣——梯形推进皮瓣的病例,这是一种非常简单的设计,可用于身体的多个部位,并且在技术上很容易复制。与其他局部皮瓣相比,该技术能以最小的张力闭合推进组织。我们的结果显示没有皮瓣丢失,且美容效果极佳。