Application of V-Y advancement flap with facial artery perforator for the repair of midface skin defects
10.3760/cma.j.cn115330-20230814-00046
- VernacularTitle:面动脉穿支V-Y推进皮瓣在修复中面部皮肤缺损中的应用
- Author:
Xinjiang XU
1
;
Mingming TANG
;
Qingwen CHEN
;
Jingtian SHI
;
Liang HAN
;
Bin JIANG
Author Information
1. 南通大学附属肿瘤医院头颈外科，南通 226361
- Keywords:
Skin neoplasms;
Perforator flap;
Midface;
Repair
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2024;59(3):238-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of V-Y advancement flap with facial artery perforator for the repair of midface skin defects.Methods:A retrospective analysis was performed on 18 patients with facial skin cancer, including 11 males and 7 females, aged 65-83 years, who underwent the repair of midface skin defects using V-Y advancement flap with facial artery perforator in the Department of Head and Neck Surgery, Affiliated Cancer Hospital of Nantong University from January 2020 to April 2023. Medium, large or complex midface skin defects developed after surgical resections of the primary lesions. According to the defect site, size, location information of facial vessels, a V-Y advancement flap with appropriate shape was designed for each case. During the operation, the facial vessels and their perforators were retained in the pedicle of the flap, the facial nerve branches were dissected and protected, and the further denuded pedicle was determined according to actual amount of advancement. After the flap was advanced, the facial defect area was repaired without tension, and the anatomical positions and functions of the eyes, nose and mouth were restored as far as possible. Postoperative follow-ups were conducted to observe the survival rate of the flaps, postoperative complications, recurrences and metastases of tumors.Results:Midface defects of 3.0 cm×3.5 cm-6.5 cm×7.5 cm were observed after tumor resections, which involved one or more subregions. The sizes of the flaps were 3.5 cm×9.0 cm-7.0 cm×18.0 cm. All flaps were completely alive except for one with temporary local bruising. With following-up of 4-40 months, 5 of the 12 patients with lower eyelid and inner canthus invasions had lower eyelid ectropion, but no exposed keratitis was found; one case with poorly differentiated squamous cell carcinoma had lymph node metastasis in the submandibular region and underwent neck dissection again; no recurrence or metastasis occurred in the remaining cases.Conclusion:The V-Y advancement flap with facial artery perforator can be used to repair medium, large or complex midface skin defects, with a high survival rate, and the operation method is safe and reliable.
