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[摘要]
目的:观察几种不同类型转移皮瓣修复眼眶组织巨大缺损的临床效果,探讨眼眶组织巨大缺损的修复技巧。
方法:回顾性分析16例被恶性肿瘤广泛破坏眼睑、眶周皮肤、眶内球旁组织及眼球的患者。行控制性或扩大切除肿瘤后,利用眶周健康组织形成转移皮瓣进行修复缺损区,供皮处缺损区取上臂内侧或腹部全厚游离皮片修复。观察术后6mo皮瓣存活情况,分析与皮瓣存活有关的术式及皮瓣类型。
结果:患者16例中接受控制性切除肿瘤的患者12例12眼,扩大切除肿瘤者4例4眼; 缺损区采用额部或额顶部轴型皮瓣修复10例10眼,皮下蒂皮瓣4例4眼,反转皮瓣2例2眼; 术后接受放射治疗12例12眼,未接受放射治疗4例4眼,随访至术后6mo,所有皮瓣均存活。
结论:转移皮瓣是修复眼眶组织巨大缺损的安全、有效方法。
[Key word]
[Abstract]
AIM: To observe the clinical effects of large orbital tissue defect reconstructed by different types of transfer flap, and to explore the skills of repairing the great defect of the orbital tissues.
METHODS: We retrospectively analyzed 16 cases of malignant tumor extensively damaged eyelid, periorbital skin and orbital tissues, the large defect was reconstructed by transfer flap of the normal skin around the defect after controlled or extended excision the eyelid malignancies. And then, the full-thickness free skin graft on the upper arm or abdominal was used to repair the donor area. The survival situation of those flaps for 6 months was observed and the skills and types of flap related to the survival were analyzed.
RESULTS: Totally 12 of 16 cases were removed tumor by controlled resection, 4 cases accepted extended resection; the defect of 10 cases were reconstructed with forehead axile myocutaneous flap, 4 cases with subcutaneous pedicle flap, and 2 cases with folding flap. 12 patients accepted postoperative radiation therapy while the other 4 patients did not. Follow-up to six months after surgery, all flaps survived.
CONCLUSION: Reconstruction of huge orbital tissue defect by transfer flap is safe and effective.
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