目的

从临床实际需求出发，基于小阴唇组织解剖结构的特点，介绍一种小阴唇内外侧分区设计改良去皮法在小阴唇缩小术中的应用，为小阴唇缩小整形术提供一种安全的手术方式，并对其临床实用性和效果进行分析。

资料和方法

通过对3具新鲜尸体的小阴唇实施内外侧分区设计改良去皮法小阴唇缩小术，并对术后小阴唇标本标记内外侧，10％甲醛固定，石蜡包埋，切片后，行常规组织学检测(HE染色)，对组织切片进行图像分析，识别小阴唇组织解剖结构，为该手术可行性提供解剖学基础。

自2015年2月至2017年10月，对32例小阴唇肥大患者采用内外侧分区设计改良去皮法的小阴唇缩小术。患者年龄20-45岁，平均年龄29岁。其中，21例为双侧小阴唇肥大，11例为单侧小阴唇肥大。双侧肥大者根据患者要求和手术原则重新设计小阴唇大小，单侧肥大者以健侧为参考设计切口。在小阴唇内外侧采用不同的设计形式非对称去除皮肤全层及少量皮下组织，术后随访1-6个月。

结果

解剖学研究显示该手术方式未损伤中央区主要血管，并有效去除小阴唇组织。  

临床32例患者，术后小阴唇组织血运良好。1例患者术后第3天小阴唇游离缘处有微小V形切口裂开，未予特殊处理，自行愈合良好，余患者均Ⅰ期愈合，小阴唇外观形态自然流畅，较术前改善显著。所有患者性生活无明显不适感，摩擦疼痛等症状消失，手术效果良好。

结论

采用该内外侧分区设计改良去皮法治疗小阴唇肥大，具有外观自然、适应症广、术后并发症少、患者满意度高的优点，是一种矫正小阴唇肥大的有效临床方法。

Objective:

Starting from clinical needs. Based on the anatomical structure of labia minora, to introduce the application of modified peeling method by divisional design in labia minora reduction and analyze its clinical outcome and practicability. To provide a practical and safe surgical procedure for labia minora reduction.

Materiails and Methods:

Three fresh cadaver materials underwent labia minora reduction by the modified peeling method by divisional design. The tissue blocks were fixed in neutral buffered formalin，embedded in paraffin，serially sectioned and stained with hematoxylin and eosin. The sections were under pathological image analysis to identify the anatomic structures of the labia minora．

From February 2015 and October 2017, of 32 nympha hypertrophy patients underwent labia minora reduction by the modified peeling method by divisional design. Divisional design in the medial and lateral labia minora, to remove the dermis and subcutaneous tissue asymmetrically. The patients were followed up at 1 to 6 months postoperatively. 

Results:

    Anatomical studies showed that the surgical method did not damage important blood vessels and nerves. In addition, It can remove the tissue

of labia minora effectively.

    All incisions of patients healed primarily with excellent blood circulation of labia minora, except for 1 case with V-shaped dehiscence. All of the patients were satisfied with the eventual aesthetic appearance and the function improvement.

Conclusions:

 The modified peeling method by divisional design in labia minora reduction is a safe and effective method with many advantages, such as nature contour, wide range of indications, fewer complications, and high satisfaction.