CAJ | 학술논문

目的探讨斧形皮瓣修复面颊部不同区域组织缺损的设计原则、效果和意义.方法利用内外眦垂直线,把面颊部分为3个区域:PⅠ、PⅡ、PⅢ.在不同区域内,参照面颊部自然曲线走向特征,在组织缺损一侧设计不同形式的斧形皮瓣,修复组织缺损.2005年8月至2009年8月,共修复面颊部中小面积组织缺损29例.其中男性17例,女性12例;年龄19～81岁,平均(45±16)岁.组织缺损面积最小者1.5 cm×1.5 cm,最大者2.5 cm×3.5 cm.术后6个月问卷调查患者对色泽和质地匹配、瘢痕隐蔽性、术区外形和功能的满意度.结果皮瓣全部成活良好.随访6～18个月,皮瓣色泽和质地匹配好,瘢痕隐蔽,术区无明显畸形,功能良好.术后6个月患者对各评价项目的满意度较高.组织缺损位于PⅠ区患者对瘢痕的满意度低于位于PⅢ区患者,两者差异有统计学意义(P=0.028).结论参照面颊部不同区域自然曲线特征,设计不同形式的斧形皮瓣修复组织缺损,能够取得较佳的视觉效果和功能恢复.
목적 탐토부형피판수복면협부불동구역조직결손적설계원칙、효과화의의.방법 이용내외자수직선,파면협부분위3개구역:PⅠ、PⅡ、PⅢ.재불동구역내,삼조면협부자연곡선주향특정,재조직결손일측설계불동형식적부형피판,수복조직결손.2005년8월지2009년8월,공수복면협부중소면적조직결손29례.기중남성17례,녀성12례;년령19～81세,평균(45±16)세.조직결손면적최소자1.5 cm×1.5 cm,최대자2.5 cm×3.5 cm.술후6개월문권조사환자대색택화질지필배、반흔은폐성、술구외형화공능적만의도.결과 피판전부성활량호.수방6～18개월,피판색택화질지필배호,반흔은폐,술구무명현기형,공능량호.술후6개월환자대각평개항목적만의도교고.조직결손위우PⅠ구환자대반흔적만의도저우위우PⅢ구환자,량자차이유통계학의의(P=0.028).결론 삼조면협부불동구역자연곡선특정,설계불동형식적부형피판수복조직결손,능구취득교가적시각효과화공능회복.
Objective To evaluate the design principles, clinical results and significance of hatchet skin flaps for repairing tissue defects in different parts of cheek. Methods The area of cheek was divided into three parts, PⅠ , PⅡ and PⅢ , with vertical lines through the medial canthus and lateral canthus. Different kinds of hatchet skin flaps were designed to repair tissue defects in different part of cheek. The hatchet skin flaps were performed in 29 cases with tissue defects in different part of cheek from August 2005 to August 2009. There were 17 male and 12 female, aged from 19 to 81 years, with a mean age of (45 ± 16 ) years. The size of tissue defect ranged from 1.5 cm × 1. 5 cm to 2. 5 cm x 3. 5 cm. Patients' satisfactions were evaluated with a questionnaire in 5 aspects:color and texture match, scar, morbidity, and function after 6 months operatively. Results All the flaps survived completely with good color and tissue match. The facial contour was not altered obviously. Six to eighteen months later, all scars were almost invisible. All 29 patients were satisfied with their results. Conclusions The hatchet skin flap is one of the versatile reconstructive methods for repairing of medium and small defects in the three parts of cheek. Defects in different part of cheek should be repaired individually with hatchet flap based on characters of natural lines.