皮肤软组织扩张术的应用探讨  

The research and aplication of skin soft-tissue expansion

作　　者：王和平[1] 宋召云[1] 叶应荣[1] 余强[1] 

机构地区：[1]中国人民解放军一五四医院烧伤整形科,河南信阳464000

出　　处：《实用美容整形外科杂志》2001年第6期289-291,共3页Journal of Practical Aesthetic and Plastic Surgery

摘　　要：目的　为了提高皮肤扩张手术的修复质量和临床效果 ,根据病损的程度、形态、部位等特点 ,对皮肤扩张器埋植和扩张后皮瓣的设计进行探讨研究。方法　通过对 87例皮肤扩张术病例分析 :①瘢痕畸形的程度、形态、部位与扩张器类型选择的关系 ;②I期手术与预扩张皮瓣的关系 ;③Ⅱ期手术皮瓣设计原则 ;④纤维囊壁与皮瓣设计的关系。结果　①皮肤缺损的形状适合选择同种形态的扩张器 ,功能部位适合长柱形或肾形扩张器 ;②扩张器应埋植在皮肤缺损邻近有足够正常皮肤或有知名血管的部位 ;③皮下的充分剥离和可靠的止血是减少并发症和提高手术质量的有效措施 ;④皮瓣蒂应选择在距缺损近 ,易转移 ,无“猫耳”的部位 ;⑤纤维囊壁应尽量剥除 ,可明显减少皮瓣回缩 ,增加皮瓣修复面积。结论　皮瓣设计贯穿皮肤扩张术全过程 ,理想的皮瓣设计可以提高修复效果 。Objective To raise the quality of repair and effect of skin soft-tissue expansion, and to research the design of flap after expansion according to the extent, form and place of the skin defect. Methods 87 cases with skin expansion were analysed as below. ①The relationship between the extent, form and place of scar deformity and the choise of expander type. ②The relationship between one-stage operation and prepared expansion flap. ③The principle of flap design in two-stage operation. ④The relationship between the fibrous cyst-wall and design of flap. Results ①It was suitable for the ordinary skin defect to select an expander similar in form. To selecte rectangular or kidney shape expander for joint region. ②The expander should be buried near in place of skin defect with enough normal skin or with named blood vessels. ③Ample peel off and reliable control of bleeding was effective measure to lessen complication and raise the operative quality. ④The flap should be selected near by to skin defect with named blood vessels, and easy to transfer, non-“dogear” without tension in suture. ⑤The flap constraction was obviously decreased and the repair area was increased by fiberous cyst-wall resection. Conclusion The flap design was run through all course of the skin soft-tissue expansion. An ideal flap design could raised the effect of repair.

关 键 词：皮肤扩张术 皮瓣设计 缺损 应用 修复 

分 类 号：R622[医药卫生—整形外科]