Clinical Application Of Table Tennis Bat Shape Flap Pedicled With The Orbicularis Oculi Muscle For Reconstruction Of Periorbital Skin Defect

Objective:To explore the clinical application of table tennis bat shape flap pedicled with the orbicularis oculi muscle for reconstruction of periorbital skin defect after the excision of eyelid and peri palpebral cutaneous tumor.Methods:We collected totally 21 cases of patients who were treated by the table tennis bat shape flap of orbicularis oculi muscle pedicle in the repair of skin defects after the excision of eyelid and peri palpebral cutaneous tumor in the department of dermatology of the second hospital of Jilin University during June 2014 to May 2017.In these cases,there were 14 cases of cutaneous basal cell carcinoma,1 case of cutaneous squamous cell carcinoma,6 cases of pigmented nevus.The patients were aged from 2 to 91 years old(average 48.8 years old)including 8 male patients and 13 female patients.The defect area sizes were from 1.0cm×0.6cm to 3.0cm×1.4cm.The the largest pedicle was 1.4cm×0.4cm,while the smallest pedicle was 0.4cm×0.2cm.All the defects were treated with the table tennis bat shape flap of orbicularis oculi muscle pedicle based on the defects location and area,while the donor sites were treated with relaxation suture hierarchically.Results:All patients were followed up form 3 to 24 months,the averaged period was 11.9 months.The survival rate of flaps is 95.2%.The total choiceness rate is 85.7% and the satisfaction rate is 76.2%.All the cases achieved good appearance and function.Only one case occurred distal partial necrosis of the flap,but finally survived after wound dressing.Donor areas healed well without scar proliferation.Conclusion:The orbicularis oculi pedicle table tennis bat shape flap has reliable blood supply as well as high flap survival rate and good ability to repair periorbital skin defect.The texture,thickness and flap color were similar with the surrounding area.Donor areas healed well and the scar was concealed without obvious proliferation.It is one of the effective methods to repair and construct the periorbital skin defect.