摘要目的 了解烧伤后鼻及邻位组织缺损的最佳修复方法 及效果. 方法 1999年1月-2008年12月,笔者单位采用额部扩张皮瓣、上臂带蒂皮瓣、耳后反流轴型岛状皮瓣及鼻唇沟皮瓣,修复烧伤后鼻部及邻位组织缺损畸形患者12例,其中全鼻缺损4例,鼻部分缺损8例.12例患者巾鼻缺损伴面颊部瘢痕3例,伴额部瘢痕5例,伴上唇外翻及上唇大部分缺损共5例.皮瓣面积3.0cm × 1.5 cm～10.0 cm×8.0 cm. 结果 采用额部扩张皮瓣修复5例、上臂带带皮瓣修复3例、耳后反流轴型岛状皮瓣修复1例、鼻唇沟皮瓣修复3例.12例皮瓣全部成活.随访1～7年,患者鼻的功能及外形均明显改善. 结论 额部皮瓣为修复烧伤后鼻缺损的首选皮瓣.面部严重烧伤,瘢痕明显,不能选择局部皮瓣或邻位皮瓣时,可考虑应用上臂带蒂皮瓣、耳后反流轴型岛状皮瓣等修复.

abstractsObjective To look for the best method of repairing nose and adjacent tissue defect after burn and observe the effect. Methods Twelve patients with post-burn nose and adjacent tissue defect de-formities hospitalized from January 1999 to December 2008 were repaired with expanded forehead flap,pedi-cled upper-arm flap, axial post-auricular reversed flow island flap,and nasolabial groove flap.Among them,4 cases with total nasal defect,8 cases with partial nasal defect;and 3 cases were accompanied with scars on cheek,5 cases accompanied with sears on forehead,5 cases accompanied with upper lip ectropion and sub-total upper lip defect.The skin flap size ranged from 3.0 cm×1.5 cm to 10.0 cm×8.0 cm. Results Five cases were repaired with expanded forehead flap.3 cases with pedieled upper-arm flap,1 case with axi-al post-auricular reversed flow island flap.and 3 cases with nasolabial groove flap respectively.All the 12 flaps survived.Patients were followed up for 1 to 7 years.and nasal function and appearance were obviously improved. Conclusions Optimal repairing method shall be chosen to repair nasal defect after burn ac-cording to its extent,and forehead flap is preferred.Pedieled upper-arm flap and reversed flow axial post-an-titular island flap can be employed if local flap and ortho-position skin flap are unavailable when obvious scar is present on face as a result of severe burn.