Repair of the defect on midface using perforator flap of facial artery

Linlin Ji ,Wei Chen ,Bo Wang ,Shujun Li ,Chao Deng ,Zairong Wei ,Hai Li ,Wenhu Jin ,Wenduo Zhang ,Yu-Ting Yuan

doi:10.3760/cma.j.issn.1009-4598.2019.04.013

Linlin Ji , Wei Chen + Show 8 more

https://doi.org/10.3760/cma.j.issn.1009-4598.2019.04.013

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Publication Date: Apr 25, 2019

Affiliation: Zunyi Medical University

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Objective To explore the clinical application of facial artery perforator flap in repairing medium-size midfacial defects. Methods Sixteen patients with facial tumors or trauma were admitted in the Affiliated Hospital of Zunyi Medical University, from October 2017 to March 2018. The patients were 41—74 years of age, including 8 males and 8 females. The tissue defects were caused by basal cell carcinoma(BCC, n=10), trauma (n=4), and squamous cell carcinoma (SqCa, n=2). The size of tumor and trauma ranged from 0.3 cm×2 cm to 2 cm×4 cm. Patients with skin tumors undergone extended radical resection, according to the nature of the tumor. Debridement was performed routinely in patients with trauma. Facial artery perforator flap was designed based on the size and shape of defect area. The scar of donor site was as parallel or hidden in the nasolabial groove. The perforator branch of the lateral nasal artery was used as the pivot point, to cover the wound surface without tension. The ipsilateral secondary relay flap pedicled with the perforator of the nasal artery was designed, which was in triangular shape and slightly larger in size than the primary flap. The pedicle was located in the middle of the flap, then the flap was pushed to cover the donor site of primary flap. The postoperative results were evaluated by patients. Results All primary and secondary relay skin flaps survived. The follow-up period of the first stage was 3—12 months, with an average of 7.5 months. There was no obvious scar, no eyelid eversion or angular deviation, and no recurrence of tumor was observed. The primary and secondary flaps have similar appearance and matched color with normal skin. Ten patients were very satisfied with the surgical outcome, and 6 were satisfied, at the latest follow-up. Conclusions The facial artery perforator relay skin flap is an alternative method to repair medium facial defect. Key words: Perforator flap; Surgical flaps; Defect; Repair

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