目的:探讨鼻尖、鼻翼、鼻小柱等鼻端部美学亚单位外伤的整形修复策略。方法:回顾性分析2013年1月至2019年12月，南京大学医学院附属鼓楼医院整形烧伤科收治的鼻端外伤及外伤修复后鼻畸形患者的病历资料。急诊一期治疗时，根据组织损伤情况，分别行原位缝合或中厚皮片移植术。二期治疗时，对于鼻翼全层缺损的患者，选择改良的耳廓复合组织瓣进行修复；对于累及多个鼻端亚单位的鼻缺损(总缺损直径在3 cm内)，分别采用局部皮瓣、鼻背皮肤扩张术结合软骨组织移植或皮片移植术进行修复。结果:该研究共纳入53例患者，男44例，女9例，年龄(42.1±17.0)岁。一期急诊就诊45例，其中33例一期原位缝合治疗，术后1年随访，患者对外形基本满意；余12例组织全层离断患者术后出现组织坏死或缺损，行二期鼻缺损修复。另有8例鼻外伤患者，在外院行急诊缝合后出现鼻端部缺损畸形就诊。20例二期修复患者中鼻翼全层缺损6例，缺损大小为1.0~7.5 cmn 2，均行改良耳廓复合组织瓣修复，大小为(1.0~3.0) cm×(1.0~2.5) cm，术后复合组织瓣大部分存活，随访1~2年，患者基本满意，对于耳廓供区存在的轻微变形，患者均能接受。鼻翼及鼻小柱缺损14例，行局部皮瓣修复4例，皮瓣大小1.5~3.0 cmn 2，术后恢复良好，其中2例在半年后行皮瓣修薄术，术后1~2年随访时患者外形基本满意；扩张器置入联合软骨移植修复4例，单纯植皮术6例，皮片大小为2~4 cmn 2，术后1~2年随访时外形良好，患者基本满意。n 结论:对于组织未完全离断以及创面清洁的鼻端部外伤美学亚单位，一期的急诊精细缝合即可获得良好的治疗效果；对于伴有软骨缺损的组织完全离断以及创面污染较重的患者需采用分期修复的治疗策略，针对不同的鼻缺损畸形采取相应的修复治疗，才能取得较好的临床治疗效果。“,”Objective:To investigate the strategy of the plastic repair of the nasal trauma involving the nasal tip, nasal alar, and columella.Methods:From January 2013 to December 2019, medical records of the patients suffering from nasal subunits trauma and postoperative nasal deformities were collected for retrospective analysis in the Department of the Burns and Plastic Surgery, the Nanjing Drum Tower Hospital. According to the traumatic condition, orthotopic suture and skin grafting were performed in the emergency department. At secondary stage, modified auricle composite tissue flap was used in the patients with full-thickness defect of nasal alar. Local flap, expanded skin of nasal dorsum combined with cartilage, skin grafting were respectively chosen in the repair of the defect involving multiple nasal subunits(the diameter of defect was less 3 cm).Results:The study included 53 patients(44 males, 9 females), the mean age was (42.1±17.0) years. 33 cases underwent in situ suturing in primary operative treatment and they were satisfied with the appearance during one-year follow-up. However, tissue necrosis occurred in 12 cases with total resection of nasal tissues, secondary reconstruction of defect was performed. 8 cases with secondary nasal deformities after extramural hospital treatment were sent to our hospital. Of 20 cases, 6 patients suffered from full-thickness defect of nasal alar( the size of defect was 1.0-7.5 cmn 2) and they were treated with modified auricle composite tissue flap, the size ranged (1.0-3.0) cm×(1.0-2.5) cm. All flaps survived and the deformity of auricle was acceptable during one-two years follow-up. The defect of nasal alar and columella occurred in 14 patients, 4 of them were treated with local flap transfer (the size was 1.5-3.0 cmn 2). Two flaps was trimmed six months after surgery and all flaps were satisfactory during one-two years follow-up. Skin expansion and cartilage graft were applied to practice in 4 patient. Skin grafting(the size of skin was 2-4 cmn 2) was used in 6 patients and all patients were satisfied with final cosmetic result.n Conclusions:When the nasal subuints was incomplete or the wound was not contaminated, cosmetic suturesat the emergency procedure can lead to good outcome. When the patient was subjected to complete tissue loss with cartilage defect or contaminated wound, staged surgical procedures were required to achieve better clinical efficacy.