扩张皮肤生物学转归临床观察.docVIP

扩张皮肤生物学转归临床观察(1.河南省人民医院整形外科　郑州450003　2.中国医学科学院整形外科医院　北京100041) 张正文,男,1966年生,1998年毕业于协和医科大学获外科学博士学位。现任河南省人民医院整形外科副主任。主要从事皮肤软组织扩张术的研究,国内外发表学术论文4篇,论著1部。 [摘　要]　目的:研究人体扩张皮肤移植后的转归。方法:采用一般观察、切口瘢痕宽度测量、皮瓣面积测算及组织学检查等对行皮肤扩张术的患者进行3个月～2年的随访。结果:①扩张皮瓣移植后3个月内松动性与弹性较差。一年后皮肤的色泽、质地、弹性等可恢复正常;②扩张部位切口瘢痕有增宽现象,主要发生于术后前3个月;③扩张皮瓣移植后有不同程度的面积缩小;④组织学结构一年后可恢复正常。结论:扩张皮肤于移植后一年左右其色泽、质地及组织学结构可恢复正常,说明皮肤扩张后的变化是暂时现象;扩张皮肤远期有不同程度的回缩现象。 [关键词]　扩张皮瓣　移植　生物学转归 [中图分类号]R622　[文献标识码]A　[文章编号]1008-6455(2000)09-0247-04 BIOLOGIC CHANGES AFTER TRANSPLANTATION OF EXPANDED HUMAN SKIN ZHANG Zheng-wen,SUN Guang-ci,CHOU Hai-yan Depart Plastic Surgery,Henan Provicial Hospital,(Zhengzhou 450003) [Abstract]　Objective:To investigate the biologic change after transplantation of expanded human skin.　Methods:The patients who had subjected to skin expansion were followed up for 3～24 months to evaluate the changes of expanded skin in appearance and elasticity,the width of scar,the area of flaps and the histologic restoration of the skin.　Results:The mobility and elasticity of expanded skin were poor within 3 months after transfer and recovered to normal about 1 year after completion of expansion procedures.Widening of the scars were observed and mainly occurred within 3 months postoperatively.The area of expanded flap had a few loss after transfer.The epidermis and dermis had returned to normal and the capsule were completely absorbed 1 year postoperatively.　Conclusions:〖WT5”BZ〗About 1 year after transplantation,the color,texture and structure of expanded skin after expansion is temporary.The contraction of expanded skin after expansion is temporary.The contraction of expanded skin occurred in some degree in the long term after transfer. [Key words]　Expanded flap　Transplantation　Biologic changes 皮肤软组织扩张术的临床应用已有多年,积累了很多的经验,近期并发症的发生率已大大降低。但随着应用时间的延长,其远期并发症如再造器官变形、切口瘢痕增宽等也时见文献报道[1,2]。综观目前有关的研究,大都集中于扩张皮肤的近期变化上,对其移植后的远期转归则研究较少,而这正是决定治疗效果的关键所在。我们在动物实验的基础上,对部分行皮肤扩张术的患者进行3个月至2年的随访,通过一般观察、切口瘢痕宽度测量、扩张皮肤面积测量和组