关键词: 鼻损伤, 缺损, 修复外科手术, 外科皮瓣

Abstract: Objective To investigate the clinical efficacy of delaying local flap repair of apical and dorsal nasal defects in nasal emergency trauma cases. Methods A retrospective analysis of eight trauma patients with apical and dorsal nasal cutaneous, subcutaneous, musculature, and cartilage defects was performed at the Department of Otorhinolaryngology Head and Neck Surgery, Ninth Peoples Hospital affiliated with Shanghai Jiaotong University School of Medicine between January 2011 and January 2014. There were seven male and one female patients; three had pure tip defects, two had simple nasal defects, and three had nasal tip defects combined with dorsum defects. All patients were initially treated with debridement and hemostasis at the emergency department before being admitted to the hospital for local dressing and systemic antibiotic therapy for 1 to 3 days. Afterwards, reconstruction of the nose with local and distant flaps was performed under general anesthesia. Results All patients were followed up for a period of 6 months to 2 years. All eight patients survived the flap without local infections or necrosis. Subjective assessments of the nasal appearance and patency performed at the short and long term follow-up visits were satisfactory to both patients and the surgeon. There was no significant impact on the quality of life of patients. Conclusion It is feasible and effective to delay the local flap repair in patients with sharp dorsal nasal defects for several days, while providing them with debridement and anti-inflammatory treatment at the emergency department. After several days of treatment and local dressing changes, the patients could tolerate surgery better.

Key words: Defects, Surgical flaps, Reconstructive surgical procedures, operative, Nose injuries