摘要
目的 观察双侧胸三角区扩张皮瓣修复面颈部重度瘢痕的效果。方法2009年4月至2012年2月，解放军第三。九医院收治9例面颈部烧伤瘢痕患者，其中男5例，女4例；年龄23～48岁，平均33岁；瘢痕位于面部5例、颈部4例；瘢痕形成时间均在半年以上，面积12cm×7cm～22em×26cm。均在胸三角区置入600—800ml扩张器，利用双侧胸三角区皮瓣扩张形成薄皮瓣同时修复双侧面颈部瘢痕。面部瘢痕修复分4次手术，颈部瘢痕修复分2次手术。供瓣区均直接拉拢缝合。术后2周观察瘢痕修复面积、皮瓣的成活情况及皮瓣质地、颜色及有无臃肿等。术后半年来院复查并调查患者对手术的满意度，以后每半年邮件随访1次。结果1例患者左侧皮瓣术后淤血经换药后愈合。其他8例患者术后皮瓣成活良好。所有患者随访6—30个月。2例患者术后皮瓣臃肿，半年后行皮瓣修整手术。其他患者术后皮瓣质地柔软，无臃肿，未行皮瓣修整。所有患者面颈部形态显著改善，患者满意度评分（7．6±2．3）分，对手术效果均满意。结论双侧胸三角区扩张薄皮瓣修复面颈部重度瘢痕效果理想。
Objective To contrive an effective method of repairing the scar in bilateral faciocervical region. Methods Between April 2009 and February 2012, 9 patients with large scars on face and neck due to burn and scald were treated. There were 5 cases with face scars and 4 cervical scars. Their average age was 33 years （range： 23 -48 years）. The disease duration was 6 months to 20 years （mean： 6. 5 years）. The scar area was 12 cm ）〈7 cm to 22 em ~ 26 cm. The soft tissue expanders （600 - 800 ml in volume） were implanted in delto-pectoral zone in one-stage operation. In two-stage operation, after the resection of cervical sears, the defects were repaired with deho-peetoral perforator flaps. In 5 facial scar cases, skin flap pedicle division was performed at Week 3. After the resection of scars, all wounds were repaired by expansion flap. The donor sites were sutured directly. The area of removed scar and the status of flap blood supply were observed. And the texture of flaps and patient satisfaction score were followed up for 6 - 30 months. Results Mild congestion of flap occurred postoperatively 1 case. The other flaps survived successfully. The flaps of 2 cases appeared bulky after transposition and flap repair was performed at Month 6. The appearance, texture, and color of flaps were similar to those at the donor sites. And there was an excellent match of flaps and recipient place. The patient satisfaction score was 7. 6 ± 2. 3. All achieved satisfactory functional and aesthetic outcomes. Conclusion The method has many advantages and its clinical application is both safe and effective.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第14期1055-1057,共3页
National Medical Journal of China
基金
国家重点基础研究发展计划（973计划）（2012CB518104）
北京市自然科学基金（7123229、7122179）
全军医学科技“十二五”重点课题（BWS11C061）
关键词
外科皮瓣
瘢痕
扩张器
Surgical flaps
Cicatrix
Expander
