游离全厚皮片联合眼周美容手术治疗眼周肿物
Application of free full-thickness skin graft combined with periocular cosmetic surgery in the treatment of periocular masses
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摘要: 目的 探讨游离全厚皮片联合眼周美容手术治疗眼周肿物的效果。方法 选择2018年9月—2021年12月就诊于徐州医科大学附属医院整形外科的11例患者,患者眼周均有肿物,包括睑黄瘤、黑色素痣,伴有上或下睑皮肤松弛,或有重睑手术意愿。手术切除肿物后,依据患者自身情况实施相应的眼周美容手术,获得眼周游离全厚皮片,根据缺损大小设计游离全厚皮片进行缺损修补。术后随访观察6个月,采用患者和观察者瘢痕评估量表(POSAS)对植皮区术后瘢痕进行评分,采用自制患者满意度调查表进行患者满意度评价。结果 11例患者共13处肿物,肿物最大为2.1 cm×1.4 cm,最小为1.2 cm×0.6 cm。术后随访观察6个月,皮片成活良好,颜色与周围皮肤无明显差异,质地柔软,眼周形态自然美观。植皮区瘢痕POSAS评分示医生对植皮区瘢痕较为满意,1位患者自觉植皮区瘢痕较厚。患者满意率为90.9%。结论 由重睑成形术、提眉术、眼袋整形术等眼周美容手术获得的游离全厚皮片,在质地、颜色等方面与周围正常皮肤相似,是眼周缺损的良好供皮区,在切除眼周肿物的同时,改善了眼周形态,达到眼周年轻化。Abstract: Objective To investigate the effect of free full-thickness skin graft combined with periocular cosmetic surgery in the treatment of periocular masses.Methods A total of 11 patients who were admitted to Department of Plastic Surgery, the Affiliated Hospital of Xuzhou Medical University from September 2018 to December 2021 were selected. All the patients had periocular masses, including xanthoma, melanin nevus, accompanied by upper or lower eyelid skin relaxation, with the intention of double eyelids. After surgical removal of the masses, the patients underwent periocular cosmetic surgeries according to their corresponding conditions to obtain a free full-thickness skin graft around the eyes. Free full-thickness skin graft was designed according to the size of defect. After six months of follow-up observation, postoperative scars in the skin graft area were scored by the patient and observer scar assessment scale(POSAS) and patient satisfaction was evaluated using a self-made patient satisfaction questionnaire.Results There were 13 masses in 11 patients. The maximum mass was 2.1 cm × 1.4 cm and the minimum was 1.2 cm × 0.6 cm. After follow-up observation of 6 months, the skin graft survived well, with soft texture. There was no significant difference in color with the surrounding skin. The eyelids, eyebrow lifting and pouch looked natural and beautiful. The POSAS scores indicated that surgeons were satisfied with the scar in the skin graft area, and one patient felt that the scar in the skin graft area was thick. The patient satisfaction rate was 90.9%.Conclusions The free full-thickness skin graft obtained from periocular cosmetic surgery such as double eyelid plasty, eyebrow lifting and pouch plastic surgery is similar to the surrounding normal skin in terms of the texture and color. It is a good skin donor area for periocular defects. With the removal of the periocular masses, the periocular region was improved in appearance, achieving periocular rejuvenation.