扩张法即刻修复Medpor外耳再造术后假体外露  

Study of removing the Medpor and transplanting an expander at the same operative stage to repair the Medpor exposure after ear reconstruction

作　　者：万睿[1] Wan Rui(The Plastic Surgery Department of Tongren Hospital of Wuhan University ＆ The Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉大学附属同仁医院暨武汉市第三医院整形外科,430060

出　　处：《中华整形外科杂志》2018年第7期552-554,共3页Chinese Journal of Plastic Surgery

基　　金：武汉市卫计委科研项目（WX14A10）

摘　　要：目的探索应用扩张器即刻置人的方法，修复Medpor外耳再造术后假体外露的临床效果。方法2013年5月至2017年2月，治疗5例外耳再造术后患者，既往手术方法均为Medpor假体置入耳后筋膜瓣包裹植皮法。外露部位为耳轮上段，手术取出Medpor假体的同时，置人50ml肾形扩张器，注水总量为80-100ml。约3个月后行二期手术，取右侧季肋部第7、8肋软骨，雕刻成耳软骨支架，植入扩张区域袋状皮瓣内，10d拆除缝线。结果5例患者再造外耳形态良好，沟回显现。无感染发生。电话、微信方式随访6-20个月，形态无明显变形，无软骨外露。5例患者均因经费原因未再行三期再造外耳修整手术。结论Medpor假体外露的耳再造患者，在创面干燥无分泌物的情况下，可于取出Medpor的即刻置人扩张器，行扩张法外耳再造可以取得良好的修复效果。Objective To explore the clinical effect by using expander implantation immediately to repair the Medpor exposure after ear reconstruction. Methods From May 2013 to February 2017, 5 patients were treated with car reconstructive surgery by Medpor implantation. The previous methods contained not only the auricular posterior fascia flap but also skin grafting. Exposed parts were the upper part of the helix and the wounds were dry without purulent secretions. Bacterial culture did not show bacterial growth. Surgical procedure was to remove the Medpor implant and implant a 50 ml kidney expander. When the wound was healed, we started to inject normal saline into the expander. About 3 months later the total volume of normal saline in the expanders were 80 - 100 ml. Then we could begin the second operation. We removed the expander and harvested the right side of the 7th and 8th rib cartilage, which were carved into the ear cartilage framework and transplanted into the expansion area. The drainage tube, negative pressure and cotton pad appropriate pressure bandage were needed. 6 days later we removed drainage tube. 10 days later we removed the suture. Results The reconstructed external ear shape in five cases were good. No infection occurred. With 6 - 20 months of follow-up using telephone and WeChat, no obvious deformation of the shape or cartilage exposure occurred. The five patients did not come back to do the third stage operation for financial considerations. They all left their hometown to work out to reduce economic pressure. Conclusions In the case of ear reconstruction for Medpor prosthesis exposure, if the wounds were not infected, removing the Medpor and transplanting an expander at the same operative stage can achieve a good therapeutic effect.

关 键 词：软组织扩张术 MEDPOR 耳廓再造术 修复 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]