八大处法耳廓再造Ⅰ期术后扩张早期感染的处理  

Treatment of Early Infection following Stage I Operation in Ear Reconstruction Using Ba Da Chu Technique

作　　者：王永振[1] 何乐人[1] 林琳[1] 蒋海越[1] 尚巧利 马辰浩[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499-501,共3页Chinese Journal of Otology

基　　金：首都临床特色应用研究(Z12110700102111);院所基金重大项目(先天性小耳畸形序列化治疗标准模式的构建);十二五国家科技支撑计划项目(2012BAII2B00)

摘　　要：目的总结并讨论扩张皮瓣下清洁冲洗加无菌化冲洗对处理八大处法耳廓再造Ⅰ期术后扩张早期感染的效果。方法回顾分析2013年7月1日至2013年7月31日我科收住的132名先天性小耳畸形患者,共埋置耳后扩张器137个,其中3例扩张器置入早期出现扩张囊腔内感染,左侧2例,右侧1例。此三例患者均为男性,分别为8岁,9岁,13岁,术后10-16天患者出现术区胀痛、局部张力增大,扩张皮瓣绯红、皮温升高,压痛阳性等表现。针对三例患者采取冲洗液为生理盐水、2%碘酒、75%酒精的扩张皮瓣下清洁冲洗加无菌化冲洗进行处理。结果本文所述3例扩张器置入术后感染患者经过5-10次冲洗后扩张皮瓣颜色恢复正常,局部症状消失,复查微生物培养结果均转阴,3例患者均恢复扩张器间断注水。注水过程中未见异常情况出现。三例患者均扩张完成并完成二期手术。结论扩张皮瓣下清洁冲洗加无菌化冲洗可以有效处理扩张器置入后扩张囊腔内早期感染,操作简单,周期短,为二期手术提供良好条件。Objective To report the effects of sub-flap cleaning-irrigation and Asepticizing-irrigation for early infec- tion after stage I operation in ear reconstruction using the Ba Da Chu method. Methods This retrospective study included 132 cases treated in July, 2013, in which 3 （all males aged at 8, 9 and 13 years respectively） showed signs of expansion cavity infec- tion, including redness, swelling, pain and local tenderness, on Days 10-16 days after Stage I surgery （2 on left and 1 on right）. We treated these three cases with cleaning-irrigation and Asepticizing-irrigation. The irrigating fluid was composed of normal saline, 2% iodine tincture and 75% alcohol. Results The expanded skin flaps in the 3 cases all returned to normal, with re- solved local symptoms and negative bacterial cultures. Skin expansion continued uneventfully thereafter and the second-stage operation was successfully completed in all three cases. Conclusion Sub-flap cleaning-irrigation and Asepticizing-irrigation is an easy, effective and time saving way to manage early infection of skin expansion cavity.

关 键 词：八大处法耳廓再造 扩张囊腔感染 清洁冲洗加无菌化冲洗 

分 类 号：R764.71[医药卫生—耳鼻咽喉科]