耳后真皮下血管网皮片游离移植治疗婴幼儿颜面先天性黑痣.docVIP

耳后真皮下血管网皮片游离移植治疗婴幼儿颜面先天性黑痣[摘要]目的:探讨耳后真皮下血管网皮片游离移植在临床治疗婴幼儿面部先天性黑痣中的临床应用价值。方法:2003年3月～2009年5月采用耳后带真皮下血管网皮片游离移植治疗3岁以内面部黑痣患者7例,大小自3.5cm×1.5cm～5cm×3.5cm。结果:所有移植皮片全部成活,术后经6个月以上随访,外观质地色泽接近周边皮肤,未见明显皮肤收缩,功能满意。结论:耳后真皮下血管网皮片游离移植治疗面部较大面积先天性黑痣操作简便易行,效果良好,尤其对于难以配合不易实施复杂治疗的幼儿患者尤为适宜。 [关键词]耳后真皮下血管网皮片;游离移植;面部黑痣 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)03-0303-03 Repairing congenital facial naevus in infants by using a post-auricular skin graftwith subdermal vascular network TIAN Jia,FAN Jin-cai,LIU Li-qiang,GAN Cheng,FENG Su-yun (The 9th Department of Plastic Surgery,Plastic Surgery Hospital,China Academy of Medical Sciences,Beijing 100144,China) Abstract:ObjectiveTo evaluate the application of the post-auricular skin graft with subdermal vascular network in the repairing of congenital facial naevus in infants.MethodsSeven patients less than 3-years’ old with the naevus lesions on their face were undergoing the treatment by using a technique of skin grafting with subdermal vascular network from the post-auricular area. The lesions were from 3.5cm×1.5cm to 5cm×3.5cm. It was carried out by excising the naevus lesion, harvesting the skin with subdermal vascular network from the post-auricular area and grafting it to the lesion wound.ResultsAll the grafts survived and over six months follow-ups were good.ConclusionThe skin graft with subdermal vascular network from the post-auricular area may be a good,simple and convenient way to repair naevus lesions on infants’ face. Key words:skin grafts with subdermal network; post-auricular area; naevus 先天性黑痣是皮肤表面含有痣细胞的色素性病变, 一般在出生后出现,并有扩大生长的特性。婴幼儿面部先天性黑痣,很大程度上影响着患儿的外观,同时也危害着患儿的健康,需要早期治疗。临床上较大面积的治疗常常选用皮片游离移植修复,但是传统的皮片移植往往远期出现移植皮片的收缩及色素沉着等并发症,从而造成外观与其周围皮肤差异较大。自2003年3月～2009年5月作者采用耳后真皮下血管网皮片游离移植治疗3岁以内婴幼儿面部先天性黑痣患者7例,获得良好的临床治疗效果。经术后较长期随访,远期疗效稳定满意。 1临床资料 本组共7例,性别:男4例,女3例,年龄10月～3岁,平均年龄2.3岁。黑痣植皮面积最小5.25cm2,最大17.5cm2,平均7.3cm2,宽度1.5～3.5cm。 2手术方法 2.1 手术常选用全身麻醉。 2.2 距黑痣边缘外2～5mm设计切口线,局部以0.5%利多卡因含肾上腺素1∶20万单位的麻醉药浸润后,切除病变全层组织。