Objective: To investigate the effectiveness of local skin flaps such as V-Y advancement flap (V-Y plasty) and transposition flap (Z plasty) in the adjustment of reconstructed nasal alars at second stage.
Methods: Between June 2012 and January 2017, 14 cases of reconstructed nasal alars by nasolabial flap or expanded forehead flap were recruited. There were 9 males and 5 females with an average age of 34.8 years (range, 18-52 years). The interval time between one- and two-stage operations was 1-12 months (mean, 3 months). The type of local skin flap was decided according to the flaws of reconstructed nasal alars. V-Y plasty was used in 5 cases, Z plasty in 2 cases, and V-Y plasty combined with Z plasty in 7 cases.
Results: All operations were successfully completed. The flaps in 3 cases suffered from epidermal necrosis at the far end and healed by dressing change. The other wounds healed by first intention. All 14 cases were followed up 6-40 months (mean, 12 months). The nasal alars had verisimilar shape and symmetrical appearance. The color and texture of reconstructed nasal alar were closed to peripheral tissues.
Conclusion: Applying local skin flaps such as V-Y plasty and Z plasty can acquire a better shape in the adjustment of reconstructed nasal alars.
目的: 探讨 V-Y 成形及 Z 成形等局部皮瓣二期修整再造鼻翼的疗效。.
方法: 2012 年 6 月—2017 年 1 月，收治 14 例因鼻翼缺损行鼻唇沟皮瓣或额部扩张皮瓣修复术后患者。男 9 例，女 5 例；年龄 18～52 岁，平均 34.8 岁。该次手术距一期手术时间为 1～12 个月，平均 3 个月。根据一期再造鼻翼不同缺陷，选择 V-Y 成形 5 例、Z 成形 2 例、V-Y 成形+ Z 成形 7 例。.
结果: 患者均顺利完成手术。术后 3 例皮瓣远端表皮部分坏死，经换药后愈合，余均Ⅰ期愈合。患者均获随访，随访时间 6～40 个月，平均 12 个月。鼻翼外形良好，与健侧基本对称；鼻翼皮肤颜色、质地与周围正常皮肤接近。.
结论: 鼻翼缺损修复再造后，二期运用 V-Y 成形、Z 成形等局部皮瓣修整鼻翼，可使再造的鼻翼形态更佳。.
Keywords: Nasal alar defect; V-Y plasty; Z plasty; local skin flap; reconstruction.