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目的:探讨鼻整形术后感染导致鼻组织缺损行早期皮瓣修复的可能性、手术时机及手术方法。方法:11例鼻整形术后感染患者,依照鼻整形手术亚单位原则,共行15例次早期皮瓣修复。缺损类型包括鼻背、鼻尖、鼻尖瘘孔;缺损面积1.5cm×1.2cm～2.0cm×2.5cm,瘘孔直径0.6～0.9cm。皮瓣类型包括鼻背瓣、菱形瓣和鼻小柱鼻尖瓣。观察修复后早期出现的鼻部结构改变及手术效果维持情况。结果:15例次皮瓣均Ⅰ期愈合。随访4～27个月,鼻外形及视觉效果良好,修复组织与周围皮肤在色泽、质地、光化性损害程度等方面匹配良好。2例鼻尖出现结构不对称,行皮下注射填充后解剖结构恢复。结论:依照鼻整形手术亚单位原则,早期合理选择个体化皮瓣修复方式,可获得较好的鼻功能性及美学效果,恢复患者社会生活交流能力。
Objective: To investigate the possibility of nasal flap defect caused by nasal plastic surgery in early stage of skin flap repair, operation timing and operation method. Methods: In the 11 patients who underwent nasal surgery, 15 cases of early skin flap were repaired according to the principles of nasal plastic surgery subunit. Types of defects include the nose back, nose tip, nose fistula hole; defect area 1.5cm × 1.2cm ~ 2.0cm × 2.5cm, fistula hole diameter 0.6 ~ 0.9cm. Types of flaps include the nasal valve, the diamond valve, and the nasal valve nasal valve. Observed early repair nasal structure changes and the effect of surgery to maintain the situation. Results: All the 15 flaps were healed by first intention. After 4 to 27 months of follow-up, the nasal shape and visual effect were good. The repaired tissue matched well with the surrounding skin in terms of color, texture and photochemical damage. 2 cases of nasal tip appear asymmetric structure, line subcutaneous injection of anatomy restored. Conclusion: According to the principles of nasal plastic surgery subunit, early rational selection of personalized skin flap repair method can get better nasal function and aesthetics, restore the ability of social life of patients.