Ratner D, Katz A, Grande D J
Department of Dermatology, Lahey Clinic, Burlington, Massachusetts 01805, USA.
Dermatol Surg. 1995 Sep;21(9):789-92. doi: 10.1111/j.1524-4725.1995.tb00298.x.
Full-thickness defects of the nasal alar rim are relatively common following Mohs micrographic surgery for the treatment of long-standing or recurrent skin tumors. Composite grafts provide an excellent cosmetic and functional alternative for the repair of such defects.
A useful technique of auricular composite graft placement for reconstruction of full-thickness nasal alar rim defects is described.
The cartilaginous portion of the graft is extended beyond the borders of the soft tissue defect so that two cartilaginous pegs frame the lateral aspects of the graft. These pegs are then inserted into pockets prepared within the alar tissue of both sides of the defect, such that the graft interlocks with its recipient bed. A series of diagrams as well as a set of photographs from a representative case are provided, along with accompanying commentary, so as to enable the surgeon to incorporate this technique easily into his/her practice.
The interlocking auricular composite graft technique permits increased graft stability, with decreased shearing forces of the graft over its recipient bed, and a larger surface area for revascularization, resulting in an increased probability of graft survival. This technique provides an elegant single stage alternative to current reconstructive techniques for full-thickness nasal alar rim defects measuring less than 1.5 cm in diameter.
在采用莫氏显微手术治疗长期存在或复发性皮肤肿瘤后，鼻翼缘全层缺损相对常见。复合移植为修复此类缺损提供了极佳的美容和功能替代方案。
描述一种用于重建鼻翼缘全层缺损的耳廓复合移植放置的实用技术。
将移植的软骨部分延伸至软组织缺损边界之外，使两个软骨柱构成移植体的侧面框架。然后将这些软骨柱插入在缺损两侧鼻翼组织内制备的腔隙中，使移植体与其受体床相互锁定。提供了一系列示意图以及一个代表性病例的一组照片，并配有说明，以便外科医生能够轻松地将该技术纳入其手术操作中。
互锁式耳廓复合移植技术可提高移植体稳定性，降低移植体在其受体床上的剪切力，并增加血管化的表面积，从而提高移植体存活的可能性。该技术为直径小于1.5 cm的鼻翼缘全层缺损的当前重建技术提供了一种出色的单阶段替代方案。
