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2017, vol. 56, br. 3, str. 101-106
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Rekonstrukcija parcijalnih defekata obrva duplim random V-Y klizajućim režnjevima
Double random V-Y advancement flaps for reconstruction of a partial eyebrow defects
aUniverzitet u Nišu, Medicinski fakultet + Klinički centar Niš, Klinika za plastičnu hirurgiju bPharmaceutical Institution, Niš
e-adresa: irenajankovic1410@gmail.com
Sažetak
Obrve su vrlo važne za pokrete lica, simetriju i ukupan estetski izgled lica. Parcijalni defekti obrva nakon ekscizije tumora mogu se rekonstruisati pomoću nekoliko hirurških tehnika, koje su često komplikovane i klinički teško izvodljive. Cilj istraživanja bio je ustanoviti pojednostavljenu hiruršku metodu rekonstrukcije parcijalnog defekta obrva pomoću ostatka tkiva obrve dvostrukim random V-Y režnjevima. U periodu od januara 2009. godine do januara 2016. godine operisano je 12 bolesnika (tri muškarca, 9 žena) sa parcijalnim defektom obrva, koji su rekonstruisani režnjevima. Starost bolesnika bila je od 48 do 82 godine. Defekti su nastali ekscizijom tumora. Defekti su bili do polovine širine obrve, lokalizovani u srednje tri četvrtine obrva. Minimalna veličina defekta bila je 0,8 cm, a maksimalna 2,5 cm. Bolesnici su operisani korišćenjem duplih random V-Y klizajućih režnjeva. Postoperativno praćenje bilo je minimalno godinu dana. Klinički efekti rekonstrukcije obrva procenjivani su pomoću formiranog sistema bodovanja. Sva 24 režnja su bila bez značajnih komplikacija i sve rekonstruisane obrve su bile u kontinuitetu, simetrične i sa dobrim integritetom. Nakon prosečno 3,28 godina praćenja, bolesnici nisu imali infekcije, recidiv tumora, a ožiljak je bio dobar. Na osnovu našeg iskustva sa 12 bolesnika kojima su obrve rekonstruisane, preporučujemo korišćenje duplih V-Y klizajućih režnjeva kao model za rekonstrukciju parcijalnih defekata obrva.
Abstract
The eyebrow region is very important for facial movements, symmetry and overall face aesthetic appearance of the face. Partial eyebrow defects after tumor excision can be repaired using several surgical techniques which are often complicated and clinically inapplicable. The aim of the study is to establish a simplified surgical method for the treatment of partial eyebrow defects using the rest of the eyebrow by the double random V-Y flaps. During the period from January 2009 to January 2016, a total of 12 patients (3 males, 9 females) with partial eyebrow defects were treated with eyebrow flap reconstruction. Patients' age ranged from 48 to 82 years. These defects were caused by tumor excision. Defects were up to half the eyebrow width, localized in the middle three quarters of the eyebrow. The minimum area of the defect was 0.8 cm and the maximum area was 2.5 cm. The patients were treated with double random V-Y advancement flaps. All the patients were followed postoperatively for at least a year. Clinical effects of eyebrow reconstruction were evaluated using a designed scoring system. All the 24 flaps survived without significant complications and all reconstructed eyebrows were continuous, symmetrical and with good integrity. After an average of 3.28 years of follow-up, the patients did not have infection, tumor recurrence, nor scarring. Based on our experience with 12 patients who underwent eyebrow reconstruction, we may recommend double V-Y advancement flaps as a model for the treatment of patients with partial eyebrow defects.
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