双侧颞浅血管同期预构颈区扩张皮瓣治疗双侧面部瘢痕挛缩畸形.doc

双侧颞浅血管同期预构颈区扩张皮瓣治疗双侧面部瘢痕挛缩畸形[摘要]目的:介绍应用颈区双蒂预构皮瓣治疗面部瘢痕畸形的方法。方法：自2006年以来，应用双侧颞浅血管束预构颈区扩张皮瓣，形成颈区左右侧双蒂皮瓣，转移修复面部瘢痕畸形13 例26侧，均为男性，年龄19～26岁。治疗时长平均为4月余。患者共同特点为：全颜面烧伤或烫伤后瘢痕挛缩畸形，面中部较严重，包括：睑外翻、鼻部分缺损畸形、口周瘢痕畸形等，颈部皮肤完好。治疗分两期，Ⅰ期：双侧颞浅血管预构颈区皮瓣，颈区皮肤扩张器植入术，扩张器注水3月余；Ⅱ期：双侧面部瘢痕挛缩畸形矫正，颈区双蒂预构扩张皮瓣转移术。设计预构扩张皮瓣最大单侧面积为：12cm×8cm。结果：26侧皮瓣均完全成活，皮瓣血供良好，供区可直接缝合，面部瘢痕挛缩得到松解。12个月后，随访5例10侧，修复效果良好，患者满意。结论：同期应用双侧颞浅血管预构颈区扩张皮瓣可同期修复双侧面部瘢痕挛缩畸形，是一种可靠的治疗面部瘢痕畸形的方法。 [关键词]预构皮瓣；颈部扩张皮瓣； 面部瘢痕 [中图分类号]R622[文献标识码]A [文章编号]1008-6455（2009）02-0141-03 Application of the prefabricated cervical expanded flap with bilateral superficial temporal vascular implantation to repair the bilateral facial scar ZHOU Chuan-de, LI Yang-qun, YANG Zhe, LI Qiang,CHEN Wen, LI Feng-yong, TANG Yong （The Tenth Plastic Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China） Abstract:ObjectiveTo investigate the feasibility of the bilateral prefabricated cervicalexpanded flap in the bilateral facial scar reparation. MethodsFrom 2006,13 cases of bilateral facial scar were reconstructed byapplication of the prefabricated cervical expanded flap with bilateral superficial temporal vascular implantation. The age ofpatients were 19-26 years and all of them were male.About 4 months to finish the treatment.The clinical aspect were that whole facial cicatricial contracture after burn. The operation was completed in two steps: ①To transfer the bilateral superficial temporal vascular through the subcutaneous tunnel into cervical area. At the same time, implant expander into the surface layer of the platysma．②After 3 months skin expansion, resect the bilateral facial scar and transfer the prefabricated island expanded flaps pedicled with bilateral superficial temporal vascular to repair the soft tissues defect .The maximal lateral area of the flap is 12cm×8cm.ResultsTotal 26 cases of prefabricated cervical expanded flap were survival and facial scar was reparation. A