修复重建和美容外科选修课6.ppt

Patients Complications Reasons Percent 1 (1st) Partial skin necrosis Without pedicle 0.3 5 (1st) Blunted convolution Failure of negative suction 1.4 1 (1st) Cartilage Extrusion Infection 0.3 3 (2nd) Cartilage exposure Strong bolster 0.9 3 (1st) Pneumothorax Perichondrium tearing 0.9 1 (1st) Helix broken Calcified cartilage 0.3 21 (2nd) Hypertrophic scars Unclear 6.0 35 10% Complications Shanghai 9th Peoples Hospital Advantages: Permanent acceptable results Precise duplication of anatomic landmarks (10) Low percentage of complications (10%) Short hospitalized time (average 3-5 days) Two stages reconstruction Shanghai 9th Peoples Hospital  Criteria of Successful Reconstructed Ear Satisfaction from the doctor, patient or relatives Accuracy in size, location and orientation Mild or no chest deformity. Well appearance on close-up view Stable, permanent and proper projection Precise duplication of anatomic landmarks (10) Future problems: Position of the reconstructed ear in hemifacial microsomia cases Atresia repair ? Avoiding scar hypertrophy Shanghai 9th Peoples Hospital Costal Cartilage with Tissue Expand Shanghai 9th Peoples Hospital Hata 1980’s JAPAN Plastic Hospital 1980’s CHINA Park 1990’s KOREA Medpor Shanghai 9th Peoples Hospital Renisch: 1990’s USA Advantages and Drawbacks Costal Cartilage with Local Skin Flap Shanghai 9th Peoples Hospital Advantages: Autogenous Short hospitalized time Fewer severe complications More favorable results Golden Standard Advantages and Drawbacks Costal Cartilage with Local Skin Flap Shanghai 9th Peoples Hospital Drawbacks: Morbidity, Pain, Scarring, and Chest-deformity Pneumothorax Absorption Favorable results are not always, especially for unfavorable conditions Advantages and Drawbacks Cartilage with Tissue Expand Shanghai 9th Peoples Hospital Advantages: Additional soft tissue supply