先天性小耳畸形耳后埋置扩张器后并发症的防治  

Prevention and Treatment of Complications from Post-Auricular Tissue Expanders in Patients with Congenital Microtia

作　　者：尚巧利 何乐人[1] 林琳[1] 杨庆华[1] 周佳宇[1] 蒋海越[1] 

机构地区：[1]北京协和医学院中国医学科学院整形外科医院整形七科,北京100144

出　　处：《中华耳科学杂志》2013年第4期496-498,共3页Chinese Journal of Otology

基　　金：基金项目:十二五国家科技支撑计划项目(2012BAII2B00);首都卫生发展科研项目(2011-4004-01);国家自然科学基金(81071113)

摘　　要：目的探讨先天性小耳畸形皮肤扩张法耳廓再造术I期术后并发症的预防及处理方法。方法对2012年6月1日至2013年5月31日在我科行耳后扩张器置入术的353例患者共368只扩张器进行回顾,其中血肿5例,感染4例,切口裂开4例,扩张皮瓣破溃扩张器外露14例,分别给予清除血肿,放置引流冲洗扩张囊腔,切口重新缝合,换药后限期手术等处理。结果 5例血肿患者清除血肿后如期完成手术,4例感染患者及4例切口裂开患者经过处理后,扩张延期7-10天,均完成了Ⅱ期手术,14例扩张皮瓣破溃者处理后限期完成手术。结论 I期术后尽管会发生各种并发症,经过恰当及时的处理后,均能得到控制,未对II期手术造成严重影响。Object To study prevention and management of complications caused by the tissue expander used behind the ear in patients with congenital microtia. Methods We reviewed data from patients with congenital microtia treated from June 1st 2012 to May 31st 2013 with post-auricular tissue expanders. A total of 368 expanders were used in 353 patients. Complications included necrosis of expanded post-auricular skin flaps （n = 14）, hematoma （n = 5）, infections （n = 4）, and rup- ture of wound （n = 4）. Timely intervention was implemented and included debridement, profuse irrigation and re-suturing of the wound with drains and follow up wound care. Results The Stage II procedure was not delayed in the 5 patients with hemato- ma after debridement. Skin expansion was extended by 7-10 days before Stage II procedure in the 4 patients with local infec- tion and the 4 patients with wound rupture. All complications had resolved before Stage II procedure after timely and appropri- ate treatment. Conclusion Complications caused by the post-auricular tissue expander are common. Choice of appropriate op- erative techniques, careful post-operative observation and timely management can help reduce complications and consequenc- es, and ensure successful treatment.

关 键 词：扩张器 并发症 耳廓再造 

分 类 号：R764.71[医药卫生—耳鼻咽喉科]