多枚扩张器联合应用修复头面颈胸部大面积组织缺损临床体会  

The clinical experience of using the multiple pieces of dilators in combination to repair tissue defects of the head,face,neck and chest

作　　者：靖昌瑞[1] 程新德[2] 曹芳[1] 任妍[1] 朱云林[2] 胡高[2] 李永忠[1] 

机构地区：[1]无锡市第二人民医院整形科,江苏无锡214002 [2]蚌埠医学院第二附属医院整形美容修复重建科

出　　处：《中国美容医学》2012年第10期1685-1687,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨多枚皮肤软组织扩张器联合应用修复头面颈胸部大面积皮肤软组织缺损的临床治疗效果。方法:对22例先天性和获得性头面颈胸部大面积皮肤软组织缺损的患者,根据缺损面积的大小及部位的不同,埋置1～3枚不等的合适形状和容量的扩张器,术后1周开始经注射壶注入生理盐水,每次注水为扩张器体积的10%,每周1～2次,待扩张达到合适的体积后,维持扩张2周,防止扩张后皮瓣术后收缩,而后切除病变组织应用旋转或推进皮瓣方法进行Ⅱ期修复创面,术后伤口愈合良好。结果:所有患者缺损区均完全覆盖,其中有2例扩张器外露,1例因导管扭曲变形,造成注水困难,后经手术外置注射壶,可继续注水。结论:多枚扩张器联合应用是各种大面积的先天性和获得性皮肤软组织缺损的很好的选择。对于扩张器植入后的并发症,要提早预防,对出现的并发症,需及时处理,否则会造成手术失败。Objective To explore the many pieces of skin and soft tissue expanders in combination to repair the clinical effects of the large head,face,neck and chest defects. Methods 22 cases of congenital and secondary skin defects in the head,face,neck and chest,according to the size of the defect area and different parts,selected and buried the right shape and capacity expansion near the defect area, one week after the operation,injected 10% volume saline of the expansion through the injection port 1 or 2 times each week until achieved to the appropriate volume, maintained the expansion two weeks,and then repaired the defect areas using rotation or advancement flap method. Summarized and comprehensive analysised the surgical techniques and results of operations. Results The patients were followed up for 1 to 3 years,all patients with defects were completely covered, no skin flap necrosis. Two cases dilator leakaged,1 case catheter distorted,after put injection port outside the skin, The dilator could continue to be injected. Conclusion The use of the multiple pieces of dilators in combination is a good choice for large area of congenital and acquired defects, To the complications of implantation of the dilator, It needed to take the prevention in advanced, In case of complications, it needed giving treatment in time, otherwise it will result in surgical failure.

关 键 词：扩张器 皮瓣 组织缺损 

分 类 号：R622[医药卫生—整形外科]