中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (2): 79-82.doi: 10.12144/zgmfskin202602079

• 论著 • 上一篇    下一篇

真皮皮下蒂皮瓣在面部皮肤肿瘤手术中的应用

付学锋,张娜,曾磊,江渊,张启盈,王美燕   

  1. 金华市中心医院皮肤科，浙江金华，321000
  • 出版日期:2026-02-15 发布日期:2026-01-28

Application of dermal-subcutaneous pedicled flap in facial skin tumor surgery

FU Xuefeng, ZHANG Na, ZENG Lei, JIANG Yuan, ZHANG Qiying, WANG Meiyan   

  1. Department of Dermatology, Jinhua Municipal Central Hospital, Jinhua 321000, China
  • Online:2026-02-15 Published:2026-01-28

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摘要： 目的：评估真皮皮下蒂皮瓣在面部皮肤肿瘤切除术后创面修复手术中的应用价值。方法：对2022年8月至2024年12月金华市中心医院皮肤科收治的肿瘤扩大切除后采用真皮皮下蒂皮瓣修复方式的面部皮肤肿瘤患者65例进行回顾性分析，并以常规邻近皮瓣30例和植皮术修复方式30例面部皮肤肿瘤患者作为对照，统计分析3种修复方式皮片存活度、瘢痕评分、患者满意度差异。结果：65例真皮皮下蒂皮瓣术后皮片血供好，无坏死，常规邻近皮瓣1例远端坏死，植皮术1例皮片部分坏死，瘢痕评分（温哥华瘢痕评价量）真皮皮下蒂皮瓣组2.72分，常规邻近皮瓣组3.80分，植皮组4.47分，患者满意度真皮皮下蒂皮瓣组9.03分，常规邻近皮瓣组8.07分，植皮组7.57分，真皮皮下蒂皮瓣在瘢痕美观度和患者满意度上显著优于常规皮瓣和植皮术（均P＜0.001），且皮片成活率与其他方法相当（P=0.021）。所有病例术后随访6个月以上未见肿瘤复发。结论：在头面部皮肤肿瘤的手术缺损修复中，真皮皮下蒂皮瓣的修复方法皮瓣存活度高，瘢痕小，美观度好，患者满意度高。

关键词: 皮肤肿瘤, 皮瓣移植, 头面部缺损修复

Abstract: Objective: To evaluate the application value of the dermal-subcutaneous pedicled flap in the repair of facial wounds after skin tumor resection. Methods: A retrospective analysis was conducted on 65 patients with facial skin tumors who underwent extended tumor resection followed by dermal-subcutaneous pedicled flap repair at the Department of Dermatology, Jinhua Central Hospital, from August 2022 to December 2024. Meanwhile, 30 patients with facial skin tumors repaired by conventional adjacent flaps and 30 patients repaired by skin grafting were selected as control groups, and the differences in flap survival rate, scar score, and patient satisfaction among the three repair methods were statistically analyzed. Results: Among the 65 cases treated with dermal-subcutaneous pedicled flaps, the postoperative flap blood supply was excellent with no necrosis; one case of distal necrosis occurred in the conventional adjacent flap group, and one case of partial skin graft necrosis was observed in the skin grafting group. The scar scores (assessed by the Vancouver Scar Scale) were 2.72 in the dermal-subcutaneous pedicled flap group, 3.80 in the conventional adjacent flap group, and 4.47 in the skin grafting group, while the patient satisfaction scores were 9.03, 8.07, and 7.57 respectively. The dermal-subcutaneous pedicled flap group was significantly superior to the conventional adjacent flap and skin grafting groups in terms of scar aesthetics and patient satisfaction (Ps＜0.001), and the flap survival rate was comparable to that of the other methods (P=0.021). No tumor recurrence was observed in all cases during a follow-up period of more than 6 months. Conclusion: In the repair of surgical defects caused by head and neck skin tumors, the dermal-subcutaneous pedicled flap repair method offers high flap survival rate, minimal scarring, excellent aesthetic outcomes, and high patient satisfaction, making it a valuable clinical option.

Key words: skin tumor, flap transplantation, head and facial defect repair