【2017年整理】局部皮瓣应用189例临床分析.docVIP

局部皮瓣应用189例临床分析 陈东来 张玉环 王喜红 (天津市长征医院整形外科天津市300021) [摘要] 目地：采用局部皮瓣修复组织缺损畸形。方法：对189例分别采用菱形皮瓣、O--T或A--T皮瓣、“Z”成形、局部旋转皮瓣、皮下蒂皮瓣和鼻唇沟皮瓣等方法。结果：应用局部皮瓣189例，除2例皮瓣尖端发生表皮坏死外均成活，切口一期愈合，形态较满意。结论：采用局部皮瓣修复组织缺损畸形，效果确定，方法简便易行。 [关键词]局部皮瓣 缺损 修复 The analysis to the 189 examples of part skin flap using Abstract: We used part skin flap to renovate the deformity of the coloboma of tisse. Method: There were 189 patient accepted this operation. To different people and different disease, we put on an operation separately in rhomboid skin flap, O-T or A-T skin flap, Z-shape, subeutaneous layor pedicle skin flap, and nasolabial skin flap. Result: In the operation we has a group of 189 skin flap but only two of which were nerosis at the top of them, the other skin flap were all alive. The incision of the first term was all healing and the appearance of it was good. Following them to make a further investigation for one to five years, we found that the seventh patient’s incision cicatrix became proliferation. But the function of it was not tortures and it didn’t influence the organ that is nearby. Conclusion: The method of renovation the deformity of the coloboma of tisse is very easy for people to use and the effect is perfect. The use of part skin flap brought great effect to the clinical. But in operation it is very important to follow the science theory of plastic surgery. And also consider the concrete situation. Prepare carefully before the operation to achieve the best effort. 局部皮瓣在临床中应用富具挑战性，如何得心应手，本文就1997年6月-2004年12月年实施局部皮瓣189例，进行临床分析： 1．1 临床资料 本组198例，其中男82例，女107例，年龄6~76岁，平均42岁，均实施局部皮瓣(6种)修复术，皮瓣应用原因，皮瓣种类、皮瓣部位及皮瓣面积见表I~IV。 表I：皮瓣应用原因 病因 例数 ％ 色素痣 72 38 疤痕 52 27.5 内眦赘皮 31 16.4 肿瘤 23 12.1 包茎 6 3.1 血管瘤 5 2.6 表Ⅱ：皮瓣种类 皮瓣种类 例数 ％ 菱形皮瓣 61 32.2 O-T或A-T皮瓣 52 23.8 “Z”成形 44 23.2 局部旋转皮瓣 16 8.4 皮下蒂皮瓣 12 6.3 鼻唇沟皮瓣 11 5.8 表III：皮瓣部位 部位 例数 ％ 头向 126 66.6 四肢 31 16.4 躯干 15 7.9 颈 7 3.7 阴茎 6 3.1 臀 4 2.1 表Ⅳ：皮瓣面积 cm2 例数 ％ 0.15-1 52 27.5 2-5 47 24.8 6-10 36