摘要
目的探讨皮下浅层组织扩张器的植入、扩张皮瓣的形成及其在面部烧伤瘢痕治疗中的应用。方法将不同大小的皮肤扩张器植入面部、颈部及上臂内侧浅筋膜层,形成薄的扩张皮瓣,带蒂移转至颜面,治疗烧伤后瘢痕228例,共用264个皮瓣。结果除14例扩张皮瓣因血肿、感染而出现皮瓣远端不同层次坏死外,其余250个皮瓣全部成活良好。皮瓣最大面积为36cm×32cm,蒂宽10～12cm。结论将皮肤扩张器植入面部浅筋膜层、颈阔肌浅层或上臂内侧深筋膜浅层,保留皮下主干浅静脉,使形成的扩张皮瓣能够以超常比例转移至面部,并达到良好成活。手术易操作,皮肤易扩张,可获得较大面积的扩张皮瓣以修复面部瘢痕。
Objective To investigate the application of skin tissue expansion at superficial layer in the treatment of face burn scar.Methods Expanders of different volume were implanted at the superficial layer of face,neck,and medial upper arm.Then the thin pedicled expanded flaps were transferred to cover face defects. 228 cases of face burn scar were treated with 264 flaps.Results 14 expander flaps underwent partial necrosis at the distal end of the flaps due to hematoma and infection.The other 250 flaps survived completely.The largest flap was 32 cm×36 cm in size with a pedicle of 10～12 cm in width.Conclusion When the expander is implanted at the superficial layer and the subcutaneous main superficial vein is reserved, the expansion flap can be transferred above the usual length to width ratio with a reliable blood supply.The technique is simple and provides a fast expansion process.
关键词
颈部
扩张皮瓣
上臂内侧
面部瘢痕
Neck
Expanded flap
Medial upper arm
Face burn scar
