Objective To investigate the clinical indications of dorsonasal flap and free full thickness skin graft in repairing the soft tissue defects in the region of nasal tip and dorsum and to compare their advantages and disadvantages based on a clinical trial. .Methods Included in this study were 28 cases with soft tissue defects in the region of nasal tip and dorsum, treated in our Hospital from July, 1997 to Feb, 2009 by the repairing technique with dorsonasal flap among 11 cases (dorsa flap group, DFG) or by that with free full thickness skin graft among 17 cases (free skin graft group, FSGG). Then, a comparative investigation was made to sum up their indications, advantages and disadvantages in clinical practice. Results Among the cases of DFG, 81.8% (9/11) were seen with nasal naevus or basal cell carcinoma. Therefore, most cases in this group were elder in their age and with relatively less soft tissue defects in the region of nasal tip and dorsum, 81.8% (9/11) of the cases with their tissue defect less than 20 mm in the diameter, fa the other hand, 76.5% (13/17) were diagnosed as traumatic defects in this region among the cases of FSGG.. So, most cases were younger in their age, and 94.1% (16/17) of them had their defects larger than 20 mm in the diameter in mis group of cases. The outcome of the repairing surgery showed that the differences in the color and skin texture of healing in the surgical area had statistical significance (P=0.0071 and 0.0068 respectively) and the scores of patients' self-evaluations on the repairing effects were also statistically significant. Conclusions Dorsonasal flap can be used to repair fee soft tissue defect in the region of nasal tip and dorsum for older patients with their defects less 20 mm in the diameter because of the properties being more lusitropic and easily transposed in the skin of the upper part of external nose. The repairing effect of this kind of flap should be superior to that of free full thickness skin graft in such a case.%目的 比较分析鼻背皮瓣与全厚游离皮片修复鼻尖鼻背部软组织缺损的临床适应症及其优缺点.方法 1997年7月至2009年2月在我科因“鼻尖鼻背软组织缺损”而治疗的患者28例,应用鼻背瓣(皮瓣组)修复11例,全厚游离皮片(皮片组)修复17例,分析其适应症及其优缺点.结果 皮瓣组以鼻部痣、基底细胞癌切除后的缺损病例为主,占81.8％(9/11),老龄居多,皮肤缺损多在20mm以下,占81.8％(9/11).皮片组以外伤后软组织缺损为主,占76.5％(13/17),中青年多见,皮肤缺损多在20mm以上,占94.1％(16/17).两组患者术后愈合色泽和平整度方面的差异有统计学意义(p=0.0071和p=0.0068),患者自评结果差异也具有统计学意义(p=0.0180).结论 由于鼻上部区域皮肤移动性较好,鼻背瓣适用于缺损直径在20mm以内的鼻尖鼻背部软组织缺损,修复效果优于全厚游离皮片.
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