皮瓣修复创面的美学效果研究  

Aesthetic effect of wound repair with flaps

作　　者：谭谦[1] 周宏礽[1] 王淑琴[1] 郑东风[1] 许澎[1] 吴杰[1] 葛华强[1] 林樾[1] 燕辛[1] 

机构地区：[1]南京大学医学院附属鼓楼医院整形烧伤科,210008

出　　处：《中华烧伤杂志》2012年第4期248-252,共5页Chinese Journal of Burns

基　　金：江苏省科技计划（国际产学研合作项目,BZ2009017）

摘　　要：目的探讨皮瓣修复创面的美学效果。方法2004年1月-2011年12月，笔者单位收治需行刨面修复的1996例患者（共计2082个创面），包括503个深度烧伤创面、268个溃疡压疮、392个外伤性皮肤软组织缺损创面、479个体表肿瘤及痣切除术后皮肤软}}l织缺损创而、314个瘢痕切除松解术后皮肤软组织缺损创而、126个其他类型创面。创面大小为1．5cm×1．0cm～30．0cm×22．0cm。把握创阿修复时机，按照皮瓣修复原则．臆用局部皮瓣、带蒂皮瓣、扩张皮瓣、游离皮瓣修复上述各类创面结果术后48h内5个皮瓣发生静脉回流障碍，其中2个皮瓣经局部按摩好转；1个皮瓣经局部应fH肝素并静脉放血后成活；1个皮瓣经急诊手术取栓、大隐静脉桥接莆新吻合后成活；1个皮瓣发生局部坏死，重新植皮后愈合。其余移植皮瓣成活良好÷1321例患者术后随访3个月～2年，皮瓣肜态良好．色泽、弹性近似正常部分患昔经过后期瘢痕整形，达到预期效果结论灵活心用皮瓣修复创面不仅愈合速度快、功能恢复好，同时可以获得较好的荚学效果．Objective To investigate the aesthetic effect of wound repair with flaps. Methods One thnusand nine hundred and ninety-six patients with 2082 wounds hospitalized frmn January 2004 to December 2011. These wounds included 503 deep hurn wounds, 268 pressure sores, 392 soft tissue defects caused hv trauma, 479 soft tissue defeets due to resection of skin cancer and mole removal, 314 soft tissue de- feels caused by sear excision, and 126 other wounds. Wound area ranged from 1.5 cm× 1.0 cm to 30.0 cm × 22.0 cm. Sliding flaps, expanded tlaps, pedicle flaps, and free flaps were used to repair the wounds in accordance with the prineiple and timing of wound repair with flaps. Results Five flaps showed venous congestion within 48 hours post-operation, 2 flaps of them improved after Io（al massage. One flap survived after local heparin wet packing and venous bloodletting. One flap survived after emergency surgical emholeetomy and bridging with saphenous vein graft. One flap strawed partial necrosis and healed after skin grafting. The other flaps survived well. One thousand three hundred and twenty-one patienls were followed up for3 months to 2 years, and flaps of them were satisfactory in shape, color, and elasticity, similar to that of normal skin. Some patients underwent scar revision later with good results. Conclusions Application of suitable flaps in wound repair will resuh in quiek wound healing, good function recovery, and satisfactory aesthetic effect.

关 键 词：外科皮瓣 创面修复 美学效果 

分 类 号：R622[医药卫生—整形外科]