Application of the horn-shaped perforator flap with multiple blood supply for reconstructing the massive facial defect
10.3760/cma.j.cn114453-20210408-00157
- VernacularTitle:多源性供血的角形穿支皮瓣修复颜面部大面积软组织缺损
- Author:
Bingcan GUO
1
;
Xiaojing LI
;
Jinlong NING
;
Xinyi LI
;
Xi LI
;
Xiaojuan WENG
;
Mingzhu GAO
Author Information
1. 安徽医科大学第一附属医院整形外科，合肥 230022
- Keywords:
Surgical flaps;
Perforator flap;
Facial defect;
Reconstruction
- From:
Chinese Journal of Plastic Surgery
2022;38(7):792-797
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the method and clinical effect of horn-shaped perforator flaps with multiple blood supply for reconstructing massive facial defects caused by various reasons.Methods:A retrospective review was performed on patients with massive facial defects in the Department of Plastic Surgery of First Affiliated Hospital of Anhui Medical University from June 2015 to July 2020. The Doppler ultrasound was used to localize the facial source artery and perforators preoperatively. During the operation, the flap was designed according to the defect size, the elasticity of around skin, the length from the distal end of the defect to the location of the selected perforator, and the Langer’s line of the face. The length of the proximal part of the flap was approximately equal to the defect width, and the length of the flap was about 3 to 3.5 times longer than the defect width. An incision was made along the distal part of the flap. The flap dissection proceeded in a proximal to distal fashion superficial to the superficial musculoaponeurotic system, until forming a large perforator flap. A small number of fibrous around the perforator were retained, and the flap was rotated and advanced to reconstruct the defect without any tension. The donor site was closed directly. Wound healing, scar formation, tumor recurrence, and tumor metastasis were followed postoperatively.Results:A total of nine cases were enrolled, with four male patients and five female patients. The mean age of the patients was 58 years, ranging from 35 to 81 years. The size of the flap ranged from 10.0 cm × 6.0 cm to 14.0 cm × 7.0 cm. All flaps survived, and the wound healed primarily. After 3 to 24 months of follow-up, no recurrence of tumor, obvious scar, flap bloated, facial deformity, or other complications were observed. The patients was satisfied with the aesthetic subunit structure and function.Conclusions:The horn-shaped perforator flap with multiple blood supply is simple in design, easy in decision, reliable in blood supply, and consistent in color and texture with the original tissue. The incision scar can be hidden in the Langer’s line with a satisfying appearance, which is suitable for aged patients with sagging facial skin.
