摘要目的 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.

abstractsObjective 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.