The reconstruction of the nasal subunits trauma
10.3760/cma.j.cn114453-20210323-00130
- VernacularTitle:鼻端外伤美学亚单位的整形外科修复
- Author:
Jian NI
1
;
Shuqin WANG
;
Xin YAN
;
Qian TAN
Author Information
1. 南京大学医学院附属鼓楼医院整形烧伤科 210008
- Keywords:
Nose;
Trauma;
Esthetics;
Ear auricle;
Tissue transplantation
- From:
Chinese Journal of Plastic Surgery
2021;37(11):1201-1207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the strategy of the plastic repair of the nasal trauma involving the nasal tip, nasal alar, and columella.Methods:From January 2013 to December 2019, medical records of the patients suffering from nasal subunits trauma and postoperative nasal deformities were collected for retrospective analysis in the Department of the Burns and Plastic Surgery, the Nanjing Drum Tower Hospital. According to the traumatic condition, orthotopic suture and skin grafting were performed in the emergency department. At secondary stage, modified auricle composite tissue flap was used in the patients with full-thickness defect of nasal alar. Local flap, expanded skin of nasal dorsum combined with cartilage, skin grafting were respectively chosen in the repair of the defect involving multiple nasal subunits(the diameter of defect was less 3 cm).Results:The study included 53 patients(44 males, 9 females), the mean age was (42.1±17.0) years. 33 cases underwent in situ suturing in primary operative treatment and they were satisfied with the appearance during one-year follow-up. However, tissue necrosis occurred in 12 cases with total resection of nasal tissues, secondary reconstruction of defect was performed. 8 cases with secondary nasal deformities after extramural hospital treatment were sent to our hospital. Of 20 cases, 6 patients suffered from full-thickness defect of nasal alar( the size of defect was 1.0-7.5 cm 2) and they were treated with modified auricle composite tissue flap, the size ranged (1.0-3.0) cm×(1.0-2.5) cm. All flaps survived and the deformity of auricle was acceptable during one-two years follow-up. The defect of nasal alar and columella occurred in 14 patients, 4 of them were treated with local flap transfer (the size was 1.5-3.0 cm 2). Two flaps was trimmed six months after surgery and all flaps were satisfactory during one-two years follow-up. Skin expansion and cartilage graft were applied to practice in 4 patient. Skin grafting(the size of skin was 2-4 cm 2) was used in 6 patients and all patients were satisfied with final cosmetic result. Conclusions:When the nasal subuints was incomplete or the wound was not contaminated, cosmetic suturesat the emergency procedure can lead to good outcome. When the patient was subjected to complete tissue loss with cartilage defect or contaminated wound, staged surgical procedures were required to achieve better clinical efficacy.
