皮肤扩张法外耳再造术后并发症的处理  

Complications of the Ear Reconstruction Using Tissue Expander and Autogenous Costal Cartilage

作　　者：石尧[1] 蒋海越[1] 林琳[1] 

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

出　　处：《医学综述》2017年第9期1805-1809,1814,共6页Medical Recapitulate

基　　金：首都临床特色应用研究(Z151100004015185);卫生科技成果与适宜技术推广项目

摘　　要：皮肤扩张技术结合自体肋软骨耳廓支架再造外耳是耳再造的主要手术术式之一。该手术虽然术式已逐渐成熟,但术后并发症仍时有发生。一旦不及时发现并处理,可能影响手术效果。皮肤扩张法外耳再造一期植入扩张器术后常见并发症主要是和扩张器相关,如发生血肿、扩张器外漏、切口裂开、感染等,分别可予清除血肿,取出扩张器,缝合切口,留置引流管进行冲洗等处理。二期肋软骨支架植入术后的常见并发症主要是和皮瓣与软骨支架相关,如血肿、植皮部分成活不良、软骨支架外漏、感染,分别可给予血肿清除,清创后皮瓣转移,清创后颞顶筋膜瓣合并皮片移植覆盖,留置引流进行抗生素盐水冲洗等处理。Using the expander and autogenous rib cartilage for ear reconstruction has become a mainstream of the ear reconstruction surgery. Although surgical technic has gradually become mature, the postoperative complications still happen, which may cause poor results if it＇ s not timely discovered and dealt with. In the first stage, the main complications are mainly related to the expander, such as hematoma, exposure of the expander, incision dehiscence, infection, necrosis of expanded skin flap, etc. The corresponding treatment methods are ： evacuation of the hematoma, removing the tissue expander, re-suturing of the wound, indwelling drainage and washing the cavity with antibiotics brines. The most common complica- tions in stage two are often associated with skin flap and cartilage scaffold, such as hematoma, obstacle of flap blood supply, cartilage exposure of framework, infection, etc. The corresponding treatment methods are： cleating away the hematoma, cleaning the invalid tissue and using the local skin flap, using temporoparietal fascia flap and skin graft, indwelling drainage and washing the cavity with antibiotics brines.

关 键 词：扩张器 皮肤扩张技术 外耳再造 并发症 外耳畸形 

分 类 号：R622[医药卫生—整形外科]