小切口及皮下减张缝合技术在皮肤软组织扩张器置入术中应用.docVIP

小切口及皮下减张缝合技术在皮肤软组织扩张器置入术中应用[摘要]目的：介绍小切口和皮下减张缝合技术在皮肤软组织扩张器置入术中的应用，以探寻更符合美学要求的软组织扩张整形美容技术。方法：根据瘢痕类型选用不同型号及形状的可控型扩张器，在局部肿胀麻醉下，经1.0～2.0cm小切口埋置扩张器。冷光源照射下，直视止血，切口皮下做减张缝合，术中注水10%～100%，切口7～10天拆线。结果：236例患者, 507个扩张部位手术均获得成功。术后切口裂开3例（0.6%），发生血肿11例（2.2%），平均埋置一 个扩张器的时间为45min，平均注水时间12周。手术时间和注水时间比常规方法缩短。结论：扩张器置入手术时应用小切口和皮下减张缝合技术具有损伤小，并发症发生率低，手术时间及注水时间缩短等优点，值得推广。 [关键词]皮肤软组织扩张术；小切口；减张缝合 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）05-0719-03 Application of the mini-incision and subcutaneous tension-reduced suture techniques in implanting the skin soft tissue expander WANG Lian-zhao1, WANG Hua-bing2, LI Bin-bin1 (1. The Sixteenth Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100041, China; 2. Beijing Hospital) Abstract:ObjectiveTo introduce the application of the mini-incision and subcutaneous tension-reduced suture techniques in implanting the skin soft tissue expander.MethodsWe selected different types and shapes of controllable expanders based on the types of scar,then implanted the expander through a 1～2cm mini-incision under local tumescent anesthesia,stop bleeding straight under the cold light. After the expander was implanted,the incision was closed with subcutaneous tension-reduced suture. 10%～100% of the expander volume was injected during the operation. The suture was removed after 7～10 days.ResultsThe surgeries were successful at 507 expander sites in 236 patients. There were 3 cases (0.6%) of wound dehiscence and 11 cases (2.2%) of hematoma. The average time of implanting an expander was 45 minutes. The average water injection time was 12 weeks. The operation time and water injection time was shorter than the regular approach.ConclusionThe application of the mini-incision and subcutaneous tension-reduced suture techniques in implanting the expander has the benefits of less damage, low rate of complication, and deceasing the operation and water injection time. It is a tech