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外伤性唇缺损修复一例

REPAIR AND RECONSTRUCTION OF LIP DEFECTS WITH VASCULARIZED SKIN FLAP

The forearm radial or ulnar vascularized cuteneuous ( or myocutaneous ) flaps were used to repair and reconstruct 17 cases of lip defects since 1981. All of the flaps were survived and their functions and contours were satisfactory, from 15 patients followed from 1-6 years. The methods of repairing lip defects and those complicated with defects of nasal vestibulum, alae nasi, nasal columella or alveolar process were also discussed. It was concluded that the forearm radial or ulnar cuteneuous (or myocutaneous) flap was suitable to repair of lipdefects.

EFFECTIVENESS OF CROSS-LIP FLAP WITH SIMUTANEOUS VASCULAR ANASTOMOSIS

ObjectiveTo investigate the feasibility and effectiveness of a modified cross-lip flap with lip artery anatomosis so as to shorten inward time. MethodsBetween August 2010 and January 2014, 11 patients underwent cross-lip flap surgery with lip artery anatomosis to repair upper lip defects. There were 9 males and 2 females with an average age of 62 years (range, 13-70 years). The defects causes were tumors removal in 6 cases, animal bites in 2 cases, and secondary deformity after cleft lip repair surgery in 3 cases. The width and height of defect were 1.5-4.0 cm and 1.8- 3.5 cm respectively; the width and height of flap were 1.5-3.2 cm and 1.5-3.0 cm respectively. The donor site was directly sutured. ResultsAll flaps survived, and wound healed by first intention. The flap pedicle was cut off at 5 days after operation. No blister, desquamation, or circulatory malfunction was found. Delayed healing of incision occurred in 1 patient with diabetes. Eleven patients were followed up 5-24 months (mean, 11 months). The patients had normal facial expression, food intake, and language function. The function of brush directional stroke test sensation recovered in 7 (77.8%) of 9 followed patients at 12 months after operation. ConclusionThe modified cross-lip flap with lip artery anatomosis is feasible and effective in repair of upper lip defects, because it can gain much more blood supply from lip right now in first surgery, shorten inward time, and relief patient's discomfort.

下唇 Abbe 皮瓣联合面颊部风筝推进皮瓣修复大面积上唇缺损

目的总结下唇 Abbe 皮瓣联合面颊部风筝推进皮瓣修复大面积上唇缺损的疗效及经验。方法2016 年 10 月—2018 年 10 月，收治 8 例大面积上唇缺损患者。男 5 例，女 3 例；年龄 7～69 岁，平均 35 岁。交通事故伤 4 例，犬咬伤 2 例，高处坠落伤 2 例。上唇部 2/3 缺损 6 例，1/2 缺损 2 例；皮肤肌肉缺损 5 例，全层组织缺损 3 例。受伤至入院时间为 20 min～4 h，平均 1.2 h。于上唇缺损区域同侧下唇设计带血管蒂的 Abbe 皮瓣，口周面颊部设计风筝推进皮瓣，联合修复上唇缺损。术后 3 周行二期断蒂修整术。结果术后皮瓣全部成活，创面均Ⅰ期愈合。4 例为进一步改善外观，分别接受唇部修整术及激光治疗。8 例均获随访，随访时间 1 个月～1 年，平均 3 个月。患者唇部外观及功能均良好，无明显瘢痕形成。结论下唇 Abbe 皮瓣联合面颊部风筝推进皮瓣修复大面积上唇缺损效果可靠。