局部皮瓣修复体表较小恶性肿瘤切除后创面.docVIP

局部皮瓣修复体表较小恶性肿瘤切除后创面[摘要]目的:探讨应用各种局部皮瓣一期修复体表较小的恶性肿瘤切除后遗留创面的优势。方法:2005年2月～2010年2月对我科收治的20例较小的体表恶性肿瘤病例,采取将较小的体表恶性肿瘤及其边缘0.5～3cm正常组织一起切除并彻底清创的方法,综合考虑创面的性质、部位、大小等因素,设计局部皮瓣一期修复切除后遗留的创面。结果:全部病例坚持随访,随访期1～5年,仅有一例复发,创面均完全愈合,皮瓣均成活,外形恢复满意,覆盖创面的组织颜色、质地与其周围组织符合性好。结论:运用灵活的局部皮瓣技术在修复体表较小的恶性肿瘤切除后遗留的创面上优势十分明显。 [关键词]局部皮瓣;恶性肿瘤;创面修复 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)05-0629-03 Using local skin flap in repairing smaller m alignant wound in the surface WANG Yan,LI Qiang,LI Sen-kai,ZHOU Chuan-de,LI Feng-yong,LI Yang-qun,HU Jin-tian,ZHOU Yu,DING Jian (The Tenth Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences,Beijing 100144,China) Abstract: Objective To stady the advantage of using various of local skin flap in primay repairing smaller m alignan wound in the surface.MethodsIn our department from February 2005 to February 2010,according to the lesion type,location,and size,smaller m alignant tumors were excised including the 0.5 to 3 cm normal tissue around the tumor and the wounds were debrided completely.The defects were immediately repaired by using local skin flap.ResultsAfter operation,all patients were persevered to follow up for 1to 5 years,with all flaps well survive and relapse in only one case. All the refractory wound healed well. The appearance results were satisfactory. The color and texture of the covered tissue was well fitted surrounding normal tissue.ConclusionA clear advantage can be achieved with plastic surgical technique for using local skin flap in repairing smaller m alignant wound in the surface. Key words:Local skin flap;m alignant tumor;repairing wound surface 基底细胞癌、鳞状细胞癌、恶性黑色素瘤、脂肪肉瘤等是常见的皮肤恶性肿瘤。整形外科界以手术切除为主要治疗手段,切除后遗留的创面可采取多种修复手段进行修复。笔者总结2005年2月～2010年2月间,我科应用局部皮瓣修复体表较小的恶性肿瘤切除后创面共20例,均取得较好的术后效果,并经过1～5年时间随访,随访结果好。因此,笔者认为应用该手术方法修复体表较小的基底细胞癌、鳞状细胞癌、恶性黑色素瘤、脂肪肉瘤等切除后创面的优点突出。现将我科这几年来的研究和应用体会介绍如下。 1临床资料 1.1 一般资料:本组20例均为经过外院综合治疗后因复发或外形不佳入院求治的病例。其中,男性14例,女性6例,年龄34～65岁。病灶性质:基底细胞癌13例、鳞状细胞癌5例、脂肪肉瘤1例、恶性黑色素瘤1例。病变位于头面部17例,躯干