耳背帶軟骨膜皮片移植修復面部黑痣切除后缺損創面_《中國修復重建外科雜志》

作者：

段偉強 , 岑瑛

四川大學華西醫院燒傷整形科（成都，610041）;

關鍵詞：

耳背帶軟骨膜皮片面部黑痣創面修復

DOI：

10.7507/1002-1892.20130293

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目的探討耳背帶軟骨膜皮片（perichondrial cutaneous graft，PCCG）移植修復面部黑痣切除后缺損的效果，并比較不同部位的療效差異。方法2008年2月－2012年10月，收治29例面部不同部位黑痣患者。男11例，女18例；年齡3～25歲，中位年齡11歲。其中上瞼黑痣5例，鼻部黑痣15例，面頰部黑痣9例。黑痣范圍1.2 cm × 1.0 cm～4.0 cm × 2.2 cm。黑痣切除后采用PCCG移植修復創面，移植皮片范圍為1.5 cm × 1.5 cm～4.2 cm × 2.5 cm。隨訪時患者對受區局部顏色、瘢痕增生、平整度的滿意程度進行評分，比較不同部位治療效果。結果術后耳背PCCG全部成活。患者均獲隨訪，隨訪時間7～15個月，平均10個月。29例PCCG移植至受區后顏色匹配好，無明顯色素沉著，瘢痕增生輕微，其中鼻部皮片平整度良好，眼瞼皮片平整度稍差。療效滿意度評分比較顯示，在顏色方面3個部位間差異無統計學意義（P gt; 0.05）；在瘢痕增生方面，鼻部評分顯著高于面頰部和上瞼（P lt; 0.05），面頰部和上瞼間差異無統計學意義（P gt; 0.05）；在平整度方面，面頰部和鼻部評分顯著高于上瞼（P lt; 0.05），面頰部與鼻部間差異無統計學意義（P gt; 0.05）。總體評分：面頰部和鼻部評分顯著高于上瞼（P lt; 0.05），鼻部評分也高于面頰部（P lt; 0.05）。結論耳背PCCG移植修復面部黑痣切除后缺損具有與受區良好的顏色匹配，在修復鼻部黑痣切除后缺損時瘢痕增生和平整度方面也令人滿意。

引用本文： 段偉強,岑瑛. 耳背帶軟骨膜皮片移植修復面部黑痣切除后缺損創面. 中國修復重建外科雜志, 2013, 27(11): 1350-1354. doi: 10.7507/1002-1892.20130293 復制

1.	Brent B, Ott R. Perichondro-cutaneous graft. Plastic Reconstr Surg, 1978, 62(1): 1-14.
2.	Stucker FJ, Walsh WE, Dammert M, et al. The perichondrial cutaneous graft: a facial reconstructive option for the ages (ages 1 week to 94 years). Laryngoscope, 2008, 118(10): 1753-1757.
3.	Inchingolo F, Tatullo M, Marrelli M, et al. Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose. Head Face Med, 2012, 8: 10.
4.	Kalbermatten DF, Haug M, Wettstein R, et al. New posterior auricular perichondrial cutaneous graft for stable reconstruction of nasal defects. Aesthetic Plast Surg, 2005, 29(6): 489-495.
5.	Arrigoni SC, Halbersma WB, Grandjean JG, et al. Patients’ satisfaction and wound-site complications after radial artery harvesting for coronary artery bypass. Interact Cardiovasc Thorac Surg, 2012, 14(3): 324-326.
6.	Bjertnaes OA, Sjetne IS, Iversen HH. Overall patient satisfaction with hospitals: effects of patient-reported experiences and fulfilment of expectations. BMJ Qual Saf, 2012, 21(1): 39-46.
7.	王欣, 王冰, 林格. 面部黑痣的治療. 中國醫藥指南, 2008, 6(15): 150-151.
8.	李波濤, 安可忍, 李萍, 等. 應用真皮下血管網皮片修復面部皮膚軟組織缺損. 中國美容醫學, 2011, 20(5): 726-727.
9.	Chaiet SR, Marcus BC. Nasal tip volume analysis after butterfly graft. Ann Plast Surg, 2012. [Epub ahead of print].
10.	婁躍君, 方柏榮, 王友彬, 等. 耳后真皮脂肪復合組織組織學特點的研究. 中國生物美容, 2009, 9(4): 1-3.
11.	高學書, 何清濂, 章惠蘭, 等. 我國成年男性30個不同部位的皮膚厚度. 第二軍醫大學學報, 1980, (3): 96-98.
12.	Tomita K, Hosokawa K, Yano K, et al. Dermal vascularity of the auricle: implications for novel composite grafts. J Plast Reconstr Aesthet Surg, 2009, 62(12): 1609-1615.
13.	Portuese W, Stucker F, Grafton W, et al. Perichondrial cutaneous graft. An alternative in composite skin grafting. Arch Otolaryngol Head Neck Surg, 1989, 115(6): 705-709.
14.	Gloster HM Jr, Brodland DG. The use of perichondrial cutaneous grafts to repair defects of the lower third of the nose. Br J Dermatol, 1997, 136(1): 43-46.
15.	Patterson AR, Brady G, Walker PD, et al. The perichondrial cutaneous graft and “flip-flop” flap in facial reconstruction: a series of 41 cases. Br J Oral Maxillofac Surg, 2008, 46(2): 114-118.
16.	Almeyda R, van der Eerden P, Vuyk H. Skin graft survival on subcutaneous hinge flaps: an algorithm for nasal reconstruction. Laryngoscope, 2013, 123(3): 605-612.
17.	Zampar AG, Salomons RL, Dornelles RF, et al. Chondrocutaneous auricular graft for reconstruction of ocular socket in anophthalmic cavities. J Craniofac Surg, 2011, 22(2): 602-605.
18.	van der Eerden P, Simmons M, Zuur K, et al. Full-thickness skin grafts and perichondrial cutaneous grafts following surgical removal of cutaneous neoplasms of the head and neck. Eur Arch Otorhinolaryngol, 2010, 267(8): 1277-1283.
19.	Larcher L, Plötzeneder I, Tasch C, et al. Retroauricular pull-through island flap for defect closure of auricular scapha defects—a safe one-stage technique. J Plast Reconstr Aesthet Surg, 2011, 64(7): 934-936.
20.	O’Driscoll SW, Fitzsimmons JS. The importance of procedure specific training in harvesting periosteum for chondrogenesis. Clin Orthop Relat Res, 2000, (380): 269-278.
21.	Van Osch GJ, Van Der Veen SW, Burger EH, et al. Chondrogenic potential of in vitro multiplied rabbit perichondrium cells cultured in alginate beads in defined medium. Tissue Eng, 2000, 6(4): 321-330.
22.	Antohi N, Isac C, Stan V, et al. Dorsal nasal augmentation with “open sandwich” graft consisting of conchal cartilage and retroauricular fascia. Aesthet Surg J, 2012, 32(7): 833-845.
23.	Sage RJ, Leach BC, Cook J. Antihelical cartilage grafts for reconstruction of mohs micrographic surgery defects. Dermatol Surg, 2012, 38(12): 1930-1937.
24.	Wong VW, Levi K, Akaishi S, et al. Scar zones: region-specific differences in skin tension may determine incisional scar formation. Plast Reconstr Surg, 2012, 129(6): 1272-1276.
25.	Suarez E, Syed F, Alonso-Rasgado T, et al. Up-regulation of tension-related proteins in keloids: knockdown of Hsp27, α2β1-integrin, and PAI-2 shows convincing reduction of extracellular matrix production. Plast Reconstr Surg, 2013, 131(2): 158e-173e.

1. Brent B, Ott R. Perichondro-cutaneous graft. Plastic Reconstr Surg, 1978, 62(1): 1-14.
2. Stucker FJ, Walsh WE, Dammert M, et al. The perichondrial cutaneous graft: a facial reconstructive option for the ages (ages 1 week to 94 years). Laryngoscope, 2008, 118(10): 1753-1757.
3. Inchingolo F, Tatullo M, Marrelli M, et al. Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose. Head Face Med, 2012, 8: 10.
4. Kalbermatten DF, Haug M, Wettstein R, et al. New posterior auricular perichondrial cutaneous graft for stable reconstruction of nasal defects. Aesthetic Plast Surg, 2005, 29(6): 489-495.
5. Arrigoni SC, Halbersma WB, Grandjean JG, et al. Patients’ satisfaction and wound-site complications after radial artery harvesting for coronary artery bypass. Interact Cardiovasc Thorac Surg, 2012, 14(3): 324-326.
6. Bjertnaes OA, Sjetne IS, Iversen HH. Overall patient satisfaction with hospitals: effects of patient-reported experiences and fulfilment of expectations. BMJ Qual Saf, 2012, 21(1): 39-46.
7. 王欣, 王冰, 林格. 面部黑痣的治療. 中國醫藥指南, 2008, 6(15): 150-151.
8. 李波濤, 安可忍, 李萍, 等. 應用真皮下血管網皮片修復面部皮膚軟組織缺損. 中國美容醫學, 2011, 20(5): 726-727.
9. Chaiet SR, Marcus BC. Nasal tip volume analysis after butterfly graft. Ann Plast Surg, 2012. [Epub ahead of print].
10. 婁躍君, 方柏榮, 王友彬, 等. 耳后真皮脂肪復合組織組織學特點的研究. 中國生物美容, 2009, 9(4): 1-3.
11. 高學書, 何清濂, 章惠蘭, 等. 我國成年男性30個不同部位的皮膚厚度. 第二軍醫大學學報, 1980, (3): 96-98.
12. Tomita K, Hosokawa K, Yano K, et al. Dermal vascularity of the auricle: implications for novel composite grafts. J Plast Reconstr Aesthet Surg, 2009, 62(12): 1609-1615.
13. Portuese W, Stucker F, Grafton W, et al. Perichondrial cutaneous graft. An alternative in composite skin grafting. Arch Otolaryngol Head Neck Surg, 1989, 115(6): 705-709.
14. Gloster HM Jr, Brodland DG. The use of perichondrial cutaneous grafts to repair defects of the lower third of the nose. Br J Dermatol, 1997, 136(1): 43-46.
15. Patterson AR, Brady G, Walker PD, et al. The perichondrial cutaneous graft and “flip-flop” flap in facial reconstruction: a series of 41 cases. Br J Oral Maxillofac Surg, 2008, 46(2): 114-118.
16. Almeyda R, van der Eerden P, Vuyk H. Skin graft survival on subcutaneous hinge flaps: an algorithm for nasal reconstruction. Laryngoscope, 2013, 123(3): 605-612.
17. Zampar AG, Salomons RL, Dornelles RF, et al. Chondrocutaneous auricular graft for reconstruction of ocular socket in anophthalmic cavities. J Craniofac Surg, 2011, 22(2): 602-605.
18. van der Eerden P, Simmons M, Zuur K, et al. Full-thickness skin grafts and perichondrial cutaneous grafts following surgical removal of cutaneous neoplasms of the head and neck. Eur Arch Otorhinolaryngol, 2010, 267(8): 1277-1283.
19. Larcher L, Plötzeneder I, Tasch C, et al. Retroauricular pull-through island flap for defect closure of auricular scapha defects—a safe one-stage technique. J Plast Reconstr Aesthet Surg, 2011, 64(7): 934-936.
20. O’Driscoll SW, Fitzsimmons JS. The importance of procedure specific training in harvesting periosteum for chondrogenesis. Clin Orthop Relat Res, 2000, (380): 269-278.
21. Van Osch GJ, Van Der Veen SW, Burger EH, et al. Chondrogenic potential of in vitro multiplied rabbit perichondrium cells cultured in alginate beads in defined medium. Tissue Eng, 2000, 6(4): 321-330.
22. Antohi N, Isac C, Stan V, et al. Dorsal nasal augmentation with “open sandwich” graft consisting of conchal cartilage and retroauricular fascia. Aesthet Surg J, 2012, 32(7): 833-845.
23. Sage RJ, Leach BC, Cook J. Antihelical cartilage grafts for reconstruction of mohs micrographic surgery defects. Dermatol Surg, 2012, 38(12): 1930-1937.
24. Wong VW, Levi K, Akaishi S, et al. Scar zones: region-specific differences in skin tension may determine incisional scar formation. Plast Reconstr Surg, 2012, 129(6): 1272-1276.
25. Suarez E, Syed F, Alonso-Rasgado T, et al. Up-regulation of tension-related proteins in keloids: knockdown of Hsp27, α2β1-integrin, and PAI-2 shows convincing reduction of extracellular matrix production. Plast Reconstr Surg, 2013, 131(2): 158e-173e.

《中國修復重建外科雜志》

耳背帶軟骨膜皮片移植修復面部黑痣切除后缺損創面

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《中國修復重建外科雜志》

耳背帶軟骨膜皮片移植修復面部黑痣切除后缺損創面

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