扩张皮瓣在头面颈部皮肤缺损修复中应用.docVIP

扩张皮瓣在头面颈部皮肤缺损修复中应用[摘要]目的:探讨皮肤扩张皮瓣在头面、颈部皮肤各类缺损修复中的手术方法及临床疗效。方法:总结自2004年以来,应用扩张皮瓣修复头面、颈部皮肤缺损患者23例,根据缺损不同部位情况设计扩张器的大小、形状及埋置方式,二期以旋转,推进,轴形皮瓣方式转移扩张皮瓣修复缺损区。结果:所有23例患者的共使用扩张器36只,一次修复缺损面积最大16.0cm×12.0cm,出现扩张器渗漏1例及扩张器外露1 例则选择二期扩张器置入,并发血肿、感染1例,发生率约13%。术后皮瓣均成活,修复后形态自然。随访3个月至5年,疗效满意。结论:充分做好术前设计,提高手术技巧的前提下应用扩张皮瓣是修复头面、颈部皮肤缺损的理想选择。 [关键词]皮肤扩张器;头面部;皮肤缺损;皮瓣 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)04-0465-03 The clinical application of expanded skin flap in repairing of the head, face and neck skin defects DENG Jian-ping,HUANG Yan-xiang,PEI Chun-yan,HUANG Wei (Department of Plastic and Aesthetic Surgery, Gaozhou People’s Hospital, Gaozhou 525200,Guangdong, China) Abstract:ObjectiveTo discuss the surgical methods and clinical efficacy of the expanded skin flap in repairing of the head, face and neck skin defects.MethodsSummary of 23 cases with skin defects in head, face and neck were repaired with expanded flaps since 2004. Designed the size, shape and embedded way of the dilator according to the location of their defects,expanded the flap with saline regularly,and transferred the expanded flaps through rotation,advancement or axial flap to repair the defects in a second surgery.Results36 dilators were used in the all 23 cases, repaired defect in the largest area of 16.0 cm × 12.0cm. One dilator leaked and one exposed were embedded another dilator ,and complicated by hematoma,infection in one case,occurrence rate of about 13%.All flaps were survived well and recovered to a natural appearance. Followed up for 3 months to 5 years, the results were satisfactory.ConclusionThe expanded skin flap is an ideal choice for the head, face and neck skin defects on the premise of fully prepared of the preoperative designs and the improvement of surgical techniques. Key words: tissue expander; head and face; skin defects; flap 头面颈部瘢痕、肿瘤、色素痣、血管瘤等切除后的修复对色泽、质地有较高的要求。传统的游离皮片移植及局部皮瓣转移,难于满足患者对美的要求。2004年1月～2009年10月,我们应用头面、颈部不同部位采用扩张器进行皮肤软组织扩张,分二期手术修复头面、颈部皮肤缺损,取得满意的效果。 1 临床资料 本