推进皮瓣与旋转皮瓣个性化修复面颊部中等面积创面临床总结OA

Objective To summarize the clinical efficacy of advancement flap and rotation flap in the repair of medium-sized defects in the cheek region,providing reference for individualized clinical decision-making.Methods 60 patients with medium-sized cheek defects following skin tumor resection from January 2020 to August 2025 were included and individually assigned to surgical procedures based on intraoperative defect morphology and local tissue conditions.32 patients with regular-shaped defects and suffcient surrounding skin laxity underwent repair with an advancement flap(advancement flap group),while 28 patients with irregularly shaped defects or those requiring greater rotational coverage were treated with a rotation flap(rotation flap group).Operative parameters,flap survival rate,primary healing rate,complications,long-term flap-related deformities,patient satisfaction,objective scar assessment,and oncological outcomes were summarized and analyzed to support individualized clinical application.Results Compared with the rotation flap group,the operative time and intraoperative blood loss in the advancement flap group were relatively low(P＜0.05).The two groups showed comparable outcomes in time to suture removal,postoperative flap survival rate,primary healing rate,and incidence of postoperative complications(P＞0.05).Flap-related deformities(dog-ear deformity and flap bulkiness)were observed only in the rotation flap group,with an incidence of 7.14%(2/28).The advancement flap group showed relatively higher patient satisfaction scores on the visual analogue scale(VAS)and relatively lower scores on the vancouver scar scale(VSS)(P＜0.05).Surgical margins were negative for all patients,and no recurrence or metastasis was observed during the follow-up period.Conclusion For medium-sized cheek defects,both advancement flap and rotation flap provide reliable outcomes in terms of flap survival,primary healing,and oncological safety.The advancement flap demonstrates high effciency and favorable aesthetic results for repairing regular defects,while the rotation flap serves as a reliable solution for complex defects,though its inherent risk of dog-ear deformity requires anticipation and management.Individualized surgical selection based on defect morphology and local tissue conditions is recommended to optimize reconstructive outcomes.