头面部体表组织缺损的修复  

Repair of Soft Tissue Defect on Craniofacial

作　　者：张茂红[1] 杜庆安[1] 宗逊[1] 

机构地区：[1]解放军第八一医院烧伤整形外科,南京市210002

出　　处：《组织工程与重建外科杂志》2007年第3期134-137,共4页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的回顾性总结头面部体表组织缺损修复的临床经验。方法对86例99处头而部体表组织缺损,分别采用分次切除或直接拉拢缝合、植皮、邻近随意皮瓣、大网膜+皮片游离移植、皮肤软组织扩张法等方法修复。结果扩张器外露1例,4例皮瓣远端小部分坏死和创面延期愈合:3例皮片部分坏死(10～15%)或水疱形成;1例大网膜坏死;77例伤口I期愈合。24例经3个月至10年随访,2例皮瓣蒂部“猫耳”需再次手术矫正;3例植皮周边疤痕增生,经再次手术矫正;3例死亡(肺部转移2例;脑溢血1例);16例功能、外形均满意,头发生长良好。结论头面部体表组织缺损的修复方法应根据患者的具体情况灵活运用,以邻近随意皮瓣的效果为好。Objective To summarize the clinical experience in repair of soft tissue defect after the resection of the craniofacial disorder. Methods 86 patlents（99） with soft tissue defect of craniofacial were studied. Direct closure, skin graft, random flaps, epiploon omentum plus skin graft and tissue expansion were applied. Results A exposed dilator occured in one case, distal necroses of minor part of flap and delayed recovery of wound in 4 cases and necrosis of the free epiploon omentum in case. Seventy-seven defects were repaired by first intention .After 3 months -10 years follow up,2 cases need to be operated again to correct the ＂cat ear＂in pedicle skin flap, 3 cases were operated again to cure the cicatrix around graft, 3 cases died （2 cases lung cancer, 1 cases cerebral hemorrhage）. All patients showed a good appearance. Conclusion Many techniques could be used for repair soft tissue defect of craniofacial. The treatment of adjacent randomized flap would be a better choice.

关 键 词：头面部 缺损修复 皮瓣 植皮 软组织扩张术 

分 类 号：R622[医药卫生—整形外科]