不同类型皮瓣修复面部深Ⅲ度烧伤创面  

Flaps in the repair of facies region with deep Ⅲ burn wounds

作　　者：刘洪琪[1] 姜孟臣[1] 侯志成[1] 朱敬民[2] 郝天智[2] 

机构地区：[1]武警医学院附属医院烧伤整形科,300162 [2]北京军区总医院

出　　处：《中华损伤与修复杂志（电子版）》2008年第3期39-41,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨面部深Ⅲ度烧伤创面皮瓣移植类型的选择方法与临床治疗效果。方法1998年1月至2007年12月应用4种类型皮瓣（共38个）移植修复面部深Ⅲ度烧伤患者32例，其中游离皮瓣2个，轴型皮瓣16个（含岛状皮瓣5个），局部皮瓣18个，皮管转移2个。结果38个移植皮瓣，除5个皮瓣远端有小面积坏死，经换药愈合，余33个皮瓣完全成活。术后随访5月～3年，移植皮瓣质地柔韧，延展性好，组织挛缩轻，皮肤色泽变化小，外形满意。结论皮瓣血运丰富，有完整的皮下脂肪组织，移植后除了可用以修复皮肤缺损外，可明显改善受区局部组织血液循环，防止感染，最大程度地恢复面部的形态与功能。术中依据创面大小和创周皮肤条件，首选局部皮瓣或轴形皮瓣，局部无条件时行游离皮瓣或皮管移植。Objective To investigate the choices and the clinical efficacy of different flaps on the repair of deep Ⅲ burn wounds in the facio-cervical region. Methods From January 1998 to December 2007,32 cases of the deep Ⅲ burn wounds in the faces region were repaired with 4 kinds of flaps,including 2 free flaps, 16 pedicle flaps, 18 local flaps, 2 tube flaps. Results Except five cases of the distal small area necrosis healed after treatment, the other 33 flaps all survived. After 5 months to 3 years, the flaps showed texture flexibility, scalability, light contracture of organizations, small changes in skin color, and satisfactory shapes. Conclusions The flaps with sufficient blood circulation and a completely subcutaneous adipose tissue after transplantation not only can be used to repair skin defects and significantly improve the local tissue blood circulation area to prevent infection, but also it is the greatest possibility of the repair of facial appearance and function. In accordance with wound size and surrounding tissues conditions, local flaps or pedicle flaps should be prefered in operation, otherwise free flaps or tube flaps be chosen.

关 键 词：皮瓣 面部 创面 修复 

分 类 号：R782.4[医药卫生—口腔医学] R644[医药卫生—临床医学]