Reconstruction of eyebrows and repair of upper eyelid defect with island flap of superficial temporal artery parietal branch

The superficial temporal artery island flap refers to an island flap made of the superficial temporal artery or the apical branch of the superficial temporal artery. Case: Male, 16 years old. Half a year ago, carbon monoxide poisoned carbon monoxide poisoning and fell on the coal stove. After the rescue, the right forehead, right top, right upper eyelid and cheeks are thick and uneven hard scars, 4/5 of the right eyebrows are all bald, and the right upper eyelids are everted. Because the scar after burn has not been softened, in order to protect the safety of the cornea, only the upper and lower eyelids are 1/2 sutured suture. One year after the injury, the scar has been softened to make the eyebrow reconstruction of the superficial right iliac artery and the upper scar and the defect repair. Treatment of diseases: congenital eyelid defects Indication 1. There are extensive and deep scars in the eyelids and their vicinity, even including eyebrow defects. It is not enough to use a rotating flap near the defect. Because of the poor local blood supply, it is impossible to use free skin grafts. 2. The full thickness defect of the eyelid. 3. Eyeball reconstruction without eyeballs. Contraindications Touch the superficial temporal artery along the hairline, and the beat is unclear or the beat is very weak. Preoperative preparation 1. Use your hand to find out if the superficial temporal artery is running and whether the beat is normal. 2. Using ultrasound Doppler technique to detect the abnormality of the superficial temporal artery and blood flow. 3. 1d shaved head (male) before surgery, or shaved (female) on the affected side of the head and forehead, washed with soapy water, rubbed with ethanol for 3 times, and sterilized dressing. Surgical procedure 1. First cut the outer half of the sacral margin suture, remove the upper right scar, so that the upper iliac crest is reset and the cleft palate is closed. 2. Do the upper defect defect impression, and make the island flap of the superficial artery top branch according to the defect impression. 3. The upper part of the island-shaped flap has hair follicles for eyebrow reconstruction and the lower half of the scar without hair follicles to repair the upper jaw defect. 4. Cut the skin along the top branch of the superficial temporal artery, and do not damage the hair follicle layer, because it is the superficial temporal artery. The subcutaneous tissue is separated to the sides above the hair follicle layer. Two incisions were made parallel to the arteries on both sides of the artery, and the incisions were made in parallel with each other, and the length was about 4 cm, so that the flap with blood vessels was free. 5. Tunneling from the pedicle of the arterial island flap to the outer superior edge of the orbital defect. 6. Move the flap through the tunnel to the defect in the right upper eyelid. 7. The top for the flap and the ankle wound are directly sutured.