The Reconstruction of Cheek Defect Using Tissue Expansion and Design of Flap Setting

以組織擴張器重建臉頰缺損及皮瓣設計

郭炳成(Ping-Cheng Kuo) ； 楊奕志(Yi-Chih Yang) ； 吳瑞星(Simon Jui-Shing Wu) ； 陳明庭(Ming-Ting Chen)

《中華民國整形外科醫學會雜誌》 17卷1期 (2008/03) Pp. 44-55

https://doi.org/10.7096/JPSA.200803.0044

摘要

利用組織擴張器來重建組織缺損是整形外科醫師常用的方式之一，然而擴張後的皮瓣如何來鋪設仍然是一個學問。作者希望能介紹擴張後皮瓣鋪設的方法，以利擴張後的組織更有效的利用。本篇文章共有八位臉頰缺損的病人利用這種皮瓣設計方式來重建臉頰部位的缺損，包括血管畸形共四人，黑毛痣共兩人，癌症切除後的缺損一人以及疤痕巒縮的一人。藉由這個新的擴張後皮瓣的設計，向內向上旋轉這個皮瓣來重建臉頰的缺損，同時在耳朵前的皮辦可以很輕易的轉移至遠處臉頰的部位。
疤痕隱藏對於臉頰重建的病人是很重要的，這些病人中皮辦都完全存活也沒有大的併發症或皮瓣的損失，一些小的併發症也可經由小的手術得到解決，而沒有長期的後遺症。利用組織擴張的方式來重建臉頰的缺損可以提供一個很好的結果同時沒有皮瓣供應區的問題。這個新的皮辦設計方式對於大範圍的臉頰缺損提供一個物盡其用的覆蓋效果。

並列摘要

Reconstruction of large cheek defects using tissue expansion is a good option for surgeons. The aim of this design is to fully utilize the expanded flap and to conceal the scar in an inconspicuous area on the face. The authors developed a new flap design after tissue expansion which can be expanded more distally to cover the cheek defect. With the proper design of the expanded tissue, one can make full utilization of the flap to cover and reach a wider and more distal defect. The key of the design is to make a proper back cut and to rotate 180 degree upward so that the flap can stretch upward to fully cover the defect. (As described in Fig. 1).
Eight patients with cheek defects were reconstructed using the new designed flap. The etiologies of the defects include vascular malformation, hairy nevus, scar contracture, and skin cancer excision.
Good coverage with minimal scarring for cheek reconstructions were achieved in all eight patients. There were no flap loss or major complications, and all minor problems were treated by minimal procedures without long term sequelae.
The reconstruction of cheek defect using tissue expansion can provide good quality of expanded tissue and obviate donor side morbidity.

並列關鍵字

cheek defect ； tissue expander ； expansion design