Email Alerts
RSS
Volume 39 Issue 9
Sep.  2023
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(9): 806-812
Chu FF,Tang YK,Ding JK,et al.Clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect[J].Chin J Burns Wounds,2023,39(9):806-812.DOI: 10.3760/cma.j.cn501225-20230517-00173.
Citation: Chu FF,Tang YK,Ding JK,et al.Clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect[J].Chin J Burns Wounds,2023,39(9):806-812.DOI: 10.3760/cma.j.cn501225-20230517-00173.
shu

Clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect

doi: 10.3760/cma.j.cn501225-20230517-00173

  • Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China

Funds:

General Program of National Natural Science Foundation of China 81971851, 82172229

More Information
    Abstract
  •   Objective   To investigate the clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect.   Methods   A retrospective observational study was conducted. From January 2012 to January 2022, 26 patients with partial nasal defects who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 19 males and 7 females, aged 5 to 61 years. The surgery was performed in 4 stages. In the first stage, a rectangular skin and soft tissue expander (hereinafter referred to as expander) with suitable rated capacity was planted in frontal region and expanded by injecting water regularly. In the second stage, flip scar flap was grafted to reconstruct nasal inner lining, whose area was about 10% larger than the area of defect. The expanded frontal flap with pedicle was transferred to repair the nasal defect, whose pedicle was supraorbital vessel or supratrochlear vessel on the contralateral side of the defect, and the area of expanded flap was 20% larger than the nasal defect area after resection and flipping of scar flap. The donor site of expanded flap was sutured directly. After 3 weeks of flap transferring, the flap was delayed in the third stage. After 1 week of delaying operation, the pedicle of flap was cut off in the fourth stage. The number, rated capacity, injection volume, and expansion time of embedded expanders were recorded. The occurrences of complications including infection, hematoma, ulceration of expanded flap after the first stage operation, and blood supply disorder or necrosis of flap after operation in the second and fourth stages were observed. All the patients were followed up for 1 year at least, and the color of flap, scar of frontal donor site, symmetry of bilateral eyebrows, and the nasal appearance and ventilated function of external nasal tract were observed.   Results   A total of 26 expanders were embedded in 26 patients. The rated capacity of expanders ranged from 100 to 300 mL. The injection volume was 1.0 to 1.5 times of the rated capacity of expanders. The expansion time ranged from 2.5 to 4.0 months, with an average time of 3 months. There were no complications occurred after each operation. The follow-up showed that the color of flap was similar to the normal nasal skin, the scar of frontal region was not obvious, the bilateral eyebrows were basically symmetrical, the nose had excellent appearance, ventilation function of external nasal tract was not affected, while some of the patients had downward rotation or unapparent tip-defining point of nose.   Conclusions   Using the flip scar flap to reconstruct the nasal inner lining and pre-expanded frontal flap to reconstruct the nasal skin, without free cartilage transplantation to repair the partial nasal defects can achieve satisfied nasal appearance post operation, without abnormal external nasal ventilation function.

     

    • FullText(HTML)
  • loading
    • References(24)
  • [1]
    BaşağaoğluB, AliK, HollierP, et al. Approach to reconstruction of nasal defects[J]. Semin Plast Surg, 2018,32(2):75-83. DOI: 10.1055/s-0038-1642639.
    [2]
    MigliorelliA,SgarzaniR,CammarotoG,et al.Reconstructive options after oncological rhinectomy: state of the art[J].Healthcare (Basel),2023,11(12):1785.DOI: 10.3390/healthcare11121785.
    [3]
    赵思纯,王珏,吴乐昊,等.鼻唇沟皮下蒂皮瓣修复鼻唇部肿物切除后皮肤缺损的效果[J].中华医学美学美容杂志,2021,27(5):411-414.DOI: 10.3760/cma.j.issn.1671-0290.2021.05.014.
    [4]
    赵琴琴,游晓波,蔡震,等.鼻翼缺损一期整复术后细节修复技巧[J].中华整形外科杂志,2018,34(11):935-938.DOI: 10.3760/cma.j.issn.1009-4598.2018.11.011.
    [5]
    ChenC,PatelR,ChiJ.Comprehensive algorithm for nasal ala reconstruction: utility of the auricular composite graft[J].Surg J (N Y),2018,4(2):e55-e61.DOI: 10.1055/s-0038-1639581.
    [6]
    YamasakiA,DermodySM,MoyerJS.Reducing risks of graft failure for composite skin-cartilage grafts[J].Facial Plast Surg Clin North Am,2023,31(2):289-296.DOI: 10.1016/j.fsc.2023.01.007.
    [7]
    ToriumiDM,KaoR,VandenbergT,et al.Auricular composite graft survival in rhinoplasty[J].Facial Plast Surg Aesthet Med,2023,25(1):6-15.DOI: 10.1089/fpsam.2022.0183.
    [8]
    龙瑞清,阮标,俞德顺,等.双侧鼻唇沟皮瓣联合修复鼻下部大范围组织缺损的临床应用[J].中华显微外科杂志,2021,44(1):71-74.DOI: 10.3760/cma.j.cn441206-20191206-00372.
    [9]
    KonofaosP,AlvarezS,McKinnieJE,et al.Nasal reconstruction: a simplified approach based on 419 operated cases[J].Aesthetic Plast Surg,2015,39(1):91-99.DOI: 10.1007/s00266-014-0417-0.
    [10]
    HanY,PanY,YangL,et al.Resurfacing partial nose defects with a retroauricular skin/cartilage free flap[J].Ann Plast Surg,2011,67(1):34-39.DOI: 10.1097/SAP.0b013e3181d50e80.
    [11]
    BrainDJ.The Indian contribution to rhinoplasty[J].J Laryngol Otol,1988,102(8):689-693.DOI: 10.1017/s0022215100106164.
    [12]
    ShayeDA.The history of nasal reconstruction[J].Curr Opin Otolaryngol Head Neck Surg,2021,29(4):259-264.DOI: 10.1097/MOO.0000000000000730.
    [13]
    鲁开化.用扩张后的额部皮瓣行鼻再造术[J].中华整形烧伤外科杂志,1989,5(3):182-183.DOI: 10.3760/cma.j.issn.1000-7806.1989.03.113.
    [14]
    YenCI,SuYJ,ChangCS,et al.Forehead flap reconstruction in different nasal defect: 58 patients' psychological outcomes[J].J Craniofac Surg,2023,34(5):1387-1392.DOI: 10.1097/SCS.0000000000009078.
    [15]
    王千文,王佳琦,宋维铭,等.额部扩张皮瓣在面颈部不同区域修复重建中的应用[J].中华整形外科杂志,2017,33(z1):43-49.DOI: 10.3760/cma.j.issn.1009-4598.2017.s1.010.
    [16]
    冀晨阳,张金明,梁伟强,等.鼻部软组织缺损不同方法修复的临床效果[J].中华医学美学美容杂志,2016,22(5):287-289.DOI: 10.3760/cma.j.issn.1671-0290.2016.05.010.
    [17]
    廖怀伟,文辉才,简雪平,等.扩张额部皮瓣修复鼻尖鼻小柱缺损[J].中华整形外科杂志,2016,32(5):378-379.DOI: 10.3760/cma.j.issn.1009-4598.2016.05.013.
    [18]
    WeiM,BuX,WangG,et al.Expanded forehead flap in Asian nasal reconstruction[J].Sci Rep,2023,13(1):5496.DOI: 10.1038/s41598-023-30245-3.
    [19]
    卢丙仑,郭树忠,马显杰,等.应用扩张皮瓣法同期修复鼻及上唇缺损[J].中华医学美学美容杂志,2012,18(3):161-163.DOI: 10.3760/cma.j.issn.1671-0290.2012.03.001.
    [20]
    WeberSM,WangTD.Options for internal lining in nasal reconstruction[J].Facial Plast Surg Clin North Am,2011,19(1):163-173.DOI: 10.1016/j.fsc.2010.10.005.
    [21]
    BurgetGC,MenickFJ.The subunit principle in nasal reconstruction[J].Plast Reconstr Surg,1985,76(2):239-247.DOI: 10.1097/00006534-198508000-00010.
    [22]
    EfthymiouV,GeorgoliosA.Techniques to enhance survival of auricular composite graft in reconstruction of skin defects of the nasal ala and nasal sidewall: a case report[J].World J Plast Surg,2022,11(3):84-88.DOI: 10.52547/wjps.11.3.84.
    [23]
    张维天,张玉君,吴红敏,等.额瓣在修复外鼻大面积缺损中的临床应用[J].临床耳鼻咽喉头颈外科杂志, 2012, 26(23):1057-1060.DOI: 10.13201/j.issn.1001-1781.2012.23.005.
    [24]
    ReckleyLK, PeckJJ, RoofeSB. Flap basics Ⅲ: interpolated flaps[J]. Facial Plast Surg Clin North Am, 2017,25(3):337-346. DOI: 10.1016/j.fsc.2017.03.006.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1753) PDF downloads(29) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return