应用皮肤软组织扩张术治疗体表肿瘤术后缺损.docVIP

应用皮肤软组织扩张术治疗体表肿瘤术后缺损[摘要]目的：探讨皮肤软组织扩张术治疗体表良性肿瘤术后缺损的效果。方法：2004年8月～2007年10月,对我科10例体表良性肿瘤患者，采取病变周围正常部位皮肤软组织内，置入扩张器，进行常规注水扩张，获得足够的额外皮肤，二期手术时彻底切除病变，应用扩张后多余的组织修复缺损。结果：术后随访分别为3月～2年,无肿瘤复发。修复部位的组织色泽、质地与周围组织基本一致,取得良好的修复效果。结论：病变周围正常皮肤软组织充分预扩张，是修复体表良性肿瘤术后缺损的良好方法，可以克服传统植皮修复的缺点。 [关键词]良性肿瘤；皮肤软组织扩张术；创面；修复 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）08-1117-03 Treatment ofthe tissue defect ofter excising superficial benign tumors by skin soft tissue expansion technique WANG Ji-hua,XIAO Hong,ZHANG Jing-bo,GUO Qun,YANG Yun,DU Yong-gui (Department of Plastic Surgery,the Second Affiliated Hospital of Kunming Medical College,Kunming 650101,Yunnan,China) Abstract：ObjectiveTo summarize the effect of using the skin soft tissue expansion technique to repair the defect after excising superficial benign tumors.Methods10 pationts with skin and soft-tissue defects after excising superficial benign tumors were repaired with skin soft tissue expansion technique in our department from August 2004 to October 2007.Results8 cases were completely repaired through one skin soft tissue expansion and 1 case was repaired through two times, 1 case was not excise completely at one time, second opertion was done after 6 months. There were not found recurrent after 3 months to 2 years of the follow-up and the results were satisfactory.ConclusionTreatment for Which the tissue defect ofter excising superficial benign tumors by skin soft tissue expansion technique is better method. Key words: superficial benign tumor; skin soft tissue expansion; skin flap; wound repair 面积较大的体表良性肿瘤切除后，继发缺损的修复是困绕整形外科医生的难题。传统的皮片移植法，因其后期存在皮肤色素沉着与周围皮肤有较大的差异，在颜面部还会导致临近器官的变形、移位，患者难以接受；未扩张的邻位皮瓣转移修复，存在供瓣面积受限，供区瘢痕明显、继发畸形等缺点，患者对手术后效果难以接受，致使一部分患者放弃治疗。2004年8月～2007年10月,笔者对10例体表良性肿瘤患者，先行病变周围或临近部位皮肤软组织预扩的方法，治疗术后组织缺损，取得了很好的修复效果。 1临床资料 本组10例，男8例,女2例，年龄8～35岁，病程8～35年。病变类型： 神经纤维瘤2例,毛细血管瘤1例,黑色素细胞痣2例,头皮疣状痣5例；病变部位：头部6例，鼻面部1例，面部2例，颈胸部1例。病变大小3cm×6cm～10cm×10cm。 2手术方法 一期手术为扩张器置入术：在肿瘤临近区域选择适当的正常组织供区,根据病变部位、大小计算出修复缺损拟需要的皮肤软组织量。根