颞浅血管蒂头皮扩张皮瓣修复面部大面积皮肤病变及缺损

摘要

目的 探讨颞浅血管蒂头皮扩张皮瓣修复面部大面积皮肤病变及缺损的临床效果.方法 2014年12月至2016年10月,广西医科大学第一附属医院整形美容外科采用颞浅血管蒂头皮扩张皮瓣移植联合激光脱毛,治疗10例不同程度大面积面部病变缺损患者,男4例,女6例,年龄19～35岁.采集患者颞顶部扩张后头皮组织标本作为试验组;另收集10例其他整形手术患者术中去除的多余颞顶部、面颊、上下眼睑、额部、鼻背正常皮肤组织作对照组.对2组皮肤厚度进行比较,并随访6个月到1年.结果 扩张后头皮瓣与面部周围皮肤组织色泽、质地基本匹配,面部轮廓、形态及美学效果满意.颞顶部扩张头皮厚度与面颊部、额部、鼻背部皮肤厚度比较,差异无统计学意义(P＞0.05),与上、下睑部皮肤厚度比较差异有统计学意义(P＜0.05).结论 颞浅血管蒂头皮扩张皮瓣移植是修复面部大面积皮肤缺损的较好方法,但在修复上、下睑皮肤缺损时,效果仍有一定不足.%Objective To investigate the therapeutic outcome of expanded scalp flaps pedicled with superficial temporal vessel for the reconstruction of large facial defects.Method From Dec 2014 to Oct 2016,10 cases with large facial skin defects were treated with expanded scalp flaps pedicled with superficial temporal vessel and delayed laser hair removal.Extra expanded scalp flaps were collected as experimental groups.Normal skin(forehead,temporal scalp,cheek,upper eyelid,lower eyelid and nasal dorsum)of 10 cases were collected for control,to compare skin thickness.All patients were followed at least 6 months.Results There was no significant difference of skin thickness between the expanded scalp flaps and cheek,forehead,nasal dorsum skin(P＞ 0.05).But upper eyelid and lower eyelids skin was significantly thinner than other local skin tissuein controls,and expanded scalp flap (P＜0.05).The expanded scalp flap matched well with surrounding tissues in color,texture and thickness.Conclusions It is a good option to repair large facial skin defects with expanded scalp flaps,pedicled with superficial temporal vessel,and laser hair removal,though its shortcoming in eyelid skin defect repairment.