软组织扩张器在头部整形修复中的应用  

Application of soft tissue expander in plastic reconstruction of head

作　　者：刘军[1] 刘建云[1] 马捷 李亚文[1] Liu Jun;Liu Jianyun;Ma Jie;Li Yawen(Department of Burn, Gansu Provincial Hospital, Lanzhou , Gansu 730000, Chin)

机构地区：[1]甘肃省人民医院烧伤科,甘肃省兰州730000

出　　处：《中国基层医药》2018年第4期457-459,J0002,J0003,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨应用软组织扩张器进行头部深度电击伤创面及瘢痕性秃发修复的手术时机及手术切口的选择.方法 收集头部高压电击伤及瘢痕性秃发患者23例,采用软组织扩张器埋置术进行创面及瘢痕性秃发区的美容修复.软组织扩张器埋置切口选择：瘢痕性秃发患者切口选在瘢痕内近毛发区域;高压电击伤患者切口位置选择依据患者伤后时间及创面修复要求不同而不同,伤后5d内手术切口可选择在距离创面约2～3 cm,伤后5 d以上患者选择远离创面切口,长约4～5 cm.结果 该组23例患者,术中、术后头皮扩张皮瓣血运良好,一期解决了高压电击伤所致的颅骨坏死外露及瘢痕性秃发,该组患者根据创面清创及修复要求采用了不同的手术切口进行软组织扩张器埋置术,术后均未发生伤口及皮瓣下感染、扩张皮瓣血运不良、坏死、扩张器外露等问题.结论 灵活采用软组织扩张器埋置手术切口,可以更为有效地适应创面修复要求,适时缩小埋置扩张器时手术剥离难度,缩短手术时间,最大可能保护健康头皮组织,并最终获得满意的临床美容修复效果.Objective To explore the timing of surgical operation and surgical incision for the treatment of head of electrical injury and scarred alopecia with soft tissue expander .Methods Twenty-three patients with high tension electrical injury and scarred alopecia were collected ,the soft tissue expander was used to repair the wound and scar area.Selected the expander to embed the incision：patients with scarred alopecia were selected to be near the hair area in the scar;high tension electrical injury in patients with incision location selection based on the time of injury and wound repair requirements vary;within 5 days after injury ,surgery incision can be selected from the wound about 2-3cm;more than 5 days after injury,the patients chose to stay away from the wound incision ,incision about 4-5cm. Results Of 23 patients,postoperative scalp expansion flap good blood supply ,a period to solve the high tension electrical injury caused by skull necrosis and scarred alopecia problems .The patients according to the wound debride-ment and repair requirements using different surgical incision for dilator implantation ,wound and flap infection ,dilated flap poor blood supply ,necrosis,dilator exposed and other issues did not occur after surgery .Conclusion Flexible use of expander embedded surgical incision can be more effectively adapted to the wound repair requirements ,timely reduction of implantation expander surgery when the difficulty of stripping ,shorten the operation time,the maximum possible protection of healthy scalp tissue ,and eventually get a satisfactory clinical cosmetic repair effect .

关 键 词：组织扩张装置 电击伤 秃发 修复外科手术 

分 类 号：R622[医药卫生—整形外科]