腹部皮肤软组织扩张术效果观察.docVIP

腹部皮肤软组织扩张术效果观察[摘要]目的：讨论腹部皮肤软组织扩张的规律和效果。方法：选取2009年2月至2010年6月入院接受腹部扩张器置入术的3例患者，埋置腹部扩张器5枚，定期注水扩张。于注水末期行腹部CT扫描。将CT扫描结果导入Mimics 10.01软件，测量模拟原腹部轮廓至扩张器内、外界的距离并比较二者大小。结果：在注水末期，2枚扩张器向外扩张距离明显大于向内扩张，1枚向内扩张距离明显大于向外扩张，2枚向内、外扩张的距离相近。结论：腹部皮肤软组织扩张术仍是获得“额外”皮肤的有效手段，但对扩张过程中皮肤增加规律尚需进一步研究明确，以利于提高扩张效率、预防潜在并发症。 [关键词]皮肤软组织扩张术；双向扩张；腹部CT [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）06-0909-03 Observation on effect of abdominal skin and soft tissue expansion WANG Huan,FAN fei,WANG Sheng,YOU Jian-jun,XU Yi-hao,HU Xiao-dong (The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science Peking Union Medical College, Beijing100144,China) Abstract： ObjectiveTo discuss the pattern and result of abdominal skin and soft tissue expansion.MethodsFrom February 2009 to June 2010,3 patients underwent abdominal skin expander implantation with together 5 expanders. The expanders were inflated regularly. At the end of the inflation, CT scan was used to analyze the expansion by mimics 10.01 software. Simulate the skin border on the axial view of the CT image,then calculate and compare the distant of internal compression and external expansion.ResultsAt the end of the expansion,2 expanders expanded more than compressed, one expander expanded less than compressed and 2 expanders expanded closely to compressed.ConclusionAbdominal expansion is still an effective method of harvesting extra skin. But more research should be done to make clear the pattern of expansion in order to improve the efficiency and prevent potential complications. Key words：Skin and soft tissue expansion;Bidirectional expansion;abdominal CT scan 整形外科临床工作中，在腹部进行皮肤扩张是获得“额外”皮肤的重要途径，也是某些情况下最好的选择。一方面，修复腹部以及胸部的皮肤缺损时需要进行腹部皮肤的扩张；另一方面，腹部体表面积大，瘢痕较易隐蔽，是理想的皮肤供区，可以通过带蒂移植和游离皮片移植的方法修复全身其他部位的皮肤缺损。但是，在腹部进行皮肤软组织扩张会遇到扩张器向腹部挤压，从而产生“双向”扩张的情况，因此，有必要对腹部皮肤软组织扩张的具体情况进行分析和讨论，从而选择理想的扩张策略。我们对我科2009年2月至2010年6月3例进行腹部皮肤扩张的患者在注水末期进行CT扫描和计算分析，尝试讨论腹部皮肤扩张的效果和方法问题。 1资料和方法 1.1 手术和注水过程：本组共3例患者，5枚腹部扩张器。根据患者情况行腹部皮