Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan, ROC.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Aesthetic Plast Surg. 2024 May;48(9):1663-1671. doi: 10.1007/s00266-023-03821-1. Epub 2024 Jan 11.
V-Y advancement flap (VYAF) is a commonly used flap for facial reconstruction, but it is not popular in Asian society with limited aesthetic outcome evaluation.
To demonstrate our experience of facial VYAF with the quantitative aesthetic outcome assessment.
From January 2013 to December 2022, patients who underwent facial VYAF reconstruction were reviewed. Postoperative photographs were collected and independently graded by three plastic surgeons, three nurses, and six non-medical personnel using Manchester scar scale (MSS). The representative preoperative images were selected for surgeons' reconstruction preferences survey.
Forty-eight patients (27 females and 21 males), with a mean age of 66.8 (23-97) years, were included in this study. All flaps survived with no flap necrosis. Only six patients (12.5%) developed minor postoperative complications, and they were treated conservatively and resolved uneventfully. The total MSS score was 7.8 ± 1.9 (scale of 4 [best scar] to 24 [worst scar]) and the overall scar VAS rating was 1.9 ± 1.1 (0 [best scar] to 10 [worst scar]), indicating satisfactory postoperative scar condition. From the survey of 22 plastic surgeons and 11 scenarios, VYAF was rarely chosen among other local flaps which only accounted for 8.7%.
VYAF is an easy and safe method for facial reconstruction with low morbidity, but its usefulness is underappreciated. With a proper design and cautious dissection, we believe that good aesthetic and functional outcomes can be achieved with VYAF.
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V-Y 推进皮瓣（VYAF）是一种常用于面部重建的皮瓣，但在亚洲社会中并不流行，因为其美学效果评估有限。
通过定量美学评估来展示我们对面部 VYAF 的应用经验。
从 2013 年 1 月至 2022 年 12 月，对接受面部 VYAF 重建的患者进行了回顾性研究。收集术后照片，并由三位整形外科医生、三位护士和六位非医务人员使用曼彻斯特疤痕量表（MSS）进行独立评分。选择有代表性的术前图像进行外科医生的重建偏好调查。
本研究纳入了 48 例患者（27 名女性和 21 名男性），平均年龄为 66.8（23-97）岁。所有皮瓣均存活，无皮瓣坏死。仅有 6 例（12.5%）患者发生轻微术后并发症，经保守治疗后均顺利解决。MSS 总评分 7.8±1.9（4 分为最佳疤痕，24 分为最差疤痕），总体疤痕 VAS 评分为 1.9±1.1（0 分为最佳疤痕，10 分为最差疤痕），表明术后疤痕状况满意。在对 22 位整形外科医生和 11 种情况进行的调查中，VYAF 在其他局部皮瓣中很少被选择，仅占 8.7%。
VYAF 是一种用于面部重建的简单、安全方法，发病率低，但它的实用性被低估了。通过适当的设计和谨慎的解剖，我们相信可以通过 VYAF 实现良好的美学和功能效果。
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