Canzoneri Christina N, Capito Anthony E
Virginia Tech Carilion Section of Plastic and Reconstructive Surgery, Roanoke, Va.
Plast Reconstr Surg Glob Open. 2023 Apr 26;11(4):e4962. doi: 10.1097/GOX.0000000000004962. eCollection 2023 Apr.
The single-stage adipofascial turnover (AFT) flap with full-thickness skin grafting is a novel technique that has been demonstrated as a safe, reliable, and cost-effective alternative to forehead flaps for nasal tip reconstruction. The purpose of this study was to compare aesthetic outcomes of these reconstructive techniques.
A retrospective review was conducted of patients who underwent either a forehead flap or an AFT flap for nasal reconstruction between January 2016 and January 2021. Aesthetic outcomes were compared via patient surveys and photographic analysis by plastic surgeons. All photographs were standardized and masked to conceal which reconstructive technique was utilized. Wilcoxon rank-sum tests and -tests were performed to determine significance.
Ten forehead flaps and 22 AFT flaps were performed between January 2016 and January 2021. Seven forehead flap patients and 18 AFT flap patients participated in the aesthetic outcome survey. Seven forehead flap postoperative photographs and 20 AFT flap postoperative photographs were available for analysis. Patients who underwent forehead flap reconstruction reported higher satisfaction for color match of the reconstruction to the surrounding nasal skin ( = 0.005). Otherwise, there was no statistical significance between the two patient groups. There was no statistical difference in the photographic analysis of the two groups.
The single-stage AFT flap with full thickness skin grafting provides similar aesthetic outcomes compared with the two-stage forehead flap when reconstructing large defects of the nasal tip, which is supported by both patient-reported outcome measures and standardized photographic analysis by a panel of plastic surgeons.
单阶段脂肪筋膜翻转（AFT）皮瓣联合全厚皮片移植是一种新技术，已被证明是用于鼻尖重建的额部皮瓣的一种安全、可靠且经济高效的替代方法。本研究的目的是比较这些重建技术的美学效果。
对2016年1月至2021年1月期间接受额部皮瓣或AFT皮瓣进行鼻重建的患者进行回顾性研究。通过患者调查和整形外科医生的照片分析来比较美学效果。所有照片均进行标准化处理并遮盖，以隐瞒使用了哪种重建技术。进行Wilcoxon秩和检验和检验以确定显著性。
2016年1月至2021年1月期间共进行了10例额部皮瓣和22例AFT皮瓣手术。7例额部皮瓣患者和18例AFT皮瓣患者参与了美学效果调查。有7张额部皮瓣术后照片和20张AFT皮瓣术后照片可供分析。接受额部皮瓣重建的患者对重建部位与周围鼻皮肤颜色匹配的满意度更高（P = 0.005）。除此之外，两组患者之间没有统计学意义。两组的照片分析没有统计学差异。
单阶段AFT皮瓣联合全厚皮片移植在重建鼻尖大缺损时与两阶段额部皮瓣相比提供了相似的美学效果，这得到了患者报告的结局指标和整形外科医生小组的标准化照片分析的支持。
