倪晓静 王坤

[摘要]目的：探讨“风筝”皮瓣修复面部皮肤缺损的效果。方法：对21例面部良恶性皮肤肿瘤手术切除后的皮肤缺损采用“风筝”皮瓣修复，手术切除病灶后，在缺损的一侧顺皮纹或皱褶线设计三角形皮瓣，使皮瓣的宽度等于或略小于缺损直径，皮瓣长度为缺损长度的2倍，以皮瓣正下方组织为蒂制作皮瓣，将皮瓣向原发缺损推进后修复创面，继发缺损皮下游离后直接缝合。结果：本组21例患者术后1周拆线，全部皮瓣存活良好，无坏死、血肿及感染等并发症发生。术后随访6个月～1年，皮瓣颜色及质地与周围皮肤相近，瘢痕不明显。结论：“风筝”皮瓣修复面部皮肤缺损疗效好，能取得较好美学效果，且临床操作难度不高，创伤小，并发症少，值得临床推广应用。

[关键词]风筝皮瓣；面部；皮肤缺损；皮肤肿瘤；修复

[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2018）04-0027-03

Clinical Application of Kite Flap to Repair Facial Skin Defect

NI Xiao-jing，WANG Kun

（Department of Dermatology，Fifth Hospital of Jinhua，Jinhua 321000，Zhejiang，China）

Abstract： Objective To explore the effect of kite flap to repair the facial skin defect. Methods 21 cases of skin defects after excision of the benign or malignant facial skin tumors were repaired with kite flap. A triangular flap along the dermatoglyphys or wrinkles was designed on the side of the defect after removing the lesion. The width of the flap was equal to or slightly smaller than the diameter of the defect， and the length of the flap was twice the length of the defect. The tissue beneath the skin flap was used as the pedicle to produce the flap. The skin flap was moved to the primary defect and applied to repaire the defect， and the secondary defect was sutured directly after subcutaneous free. Results The patients in this group were taken the stitches 1 week after the operation. All flaps survived well without complications such as necrosis， hematoma and infection. After a follow-up of 6 months to 1 year， the color and texture of the skin flap were similar to that of the surrounding skin， and the scar was not obvious. Conclusion Kite flap has good effects on reparing the facial skin defects. It can achieve aesthetic effects， and can be operated easliy with less trauma and fewer complications. Therefore， it is worthy of clinical popularization application.

Key words： kite flap； face； skin defect； skin tumor； repair

面部是影響人体容貌的主要因素，手术切除治疗面部良性与恶性皮肤肿瘤时，不但要考虑手术切除的彻底性，而且要考虑术后皮肤缺损的美容修复。如果创面小或皮肤较为松弛，多可直接缝合。但是，皮肤缺损较大或影响眼、口或鼻部外形与功能时，直接缝合困难，则需应用皮瓣或皮片修复[1]。笔者科室于2014年1月-2017年1月，应用“风筝”皮瓣修复面部良性与恶性皮肤肿瘤切除术后皮肤缺损患者21例，取得较为满意的效果，现报道如下。

1 资料和方法

1.1 一般资料：本组共21例患者，其中男14例，女7例；年龄32～83岁，平均（57.4±12.9）岁；皮损位于眼睑3例，颊部6例，鼻背10例，鼻侧壁2例；……