颞枕跨区筋膜瓣联合植皮在头皮巨大肿物切除创面修复中的应用  

Clinical application of temporal-occipital cross-area fascia flap combined with skin grafting for the repair of large scalp defect after tumor resection

作　　者：李庆林[1] LI Qing-lin(Department of Burn and Plastic Surgery,Central Hospital of Shengli Oil Field,Dongying 257034,P.R.China)

机构地区：[1]胜利油田中心医院烧伤整形美容科,山东东营257034

出　　处：《中华肿瘤防治杂志》2018年第14期1009-1012,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(81402613)

摘　　要：目的头皮肿物切除后创面完美修复一直是临床难题,各种方法均有其不足,本研究应用颞枕跨区筋膜瓣联合植皮修复巨大头皮肿物切除后创面,探讨其临床疗效和应用价值。方法选择2010-09-01-2016-08-01胜利油田中心医院巨大头皮肿物患者25例,头皮肿物切除后遗留5cm×6cm^12cm×13cm头皮缺损创面,伴有颅骨外露9例。应用颞枕跨区筋膜瓣联合大腿中厚皮片移植术修复,观察术后皮瓣成活情况,术后6个月观察皮瓣瘢痕情况和外观,并进行患者满意度调查。结果皮瓣成活率为(99.92±0.4)%,有1例筋膜瓣及皮片远端坏死,通过换药治愈,其余皮瓣均成活良好。温哥华瘢痕量表评分为(1.3±0.2)分,皮瓣瘢痕不明显,厚薄适中,弹性色泽好。患者满意度为100%。结论颞枕跨区筋膜瓣联合植皮在巨大头皮肿物切除后继发缺损创面修复中应用价值高,疗效肯定。OBJECTIVE The perfect repair of the wound after the scalp resection is always a clinical problem and various methods have its shortcomings.In this study,temporal-occipital cross-area facial flap combined skin grafting was used to repair the wound after excision of huge scalp tumor and its clinical efficacy and application value were discussed.METHODS We reviewed 25 cases of huge scalp tumor in Department of Burn and Plastic Surgery of Central Hospital of Shengli Oil Field between September 1 st,2010 and August 1 st,2016.After fully excising tumors,the area of the scalp defects ranged from 5 cm×6 cm to 12 cm×13 cm.Of these 25 patients,9 cases with skull exposure.Temporal-occipital cross-area facial flap combined with thick skin graft in the thigh were applied to repair the wound.The flap survival rate,scar condition,appearance and patient satisfaction after operation were observed and recorded at different time points.RESULTS The survival rate of the flap was（99.92±0.4）%,and 1 cases of necrosis of the fascial flap and distal skin graft were cured by dressing change,and the rest flaps survived well.The Vancouver scar scale score was（1.3±0.2）points.The scar of the flap was not obvious,the thickness was thin,the elasticity was good,and the patient satisfaction was100%.CONCLUSION The application of temporal-occipital cross-area facial flap combined with skin grafting in the repair of secondary defect after huge scalp tumor resection is of high value and definite curative effect.

关 键 词：颞枕跨区筋膜瓣 头皮肿物 创面修复 植皮 瘢痕 

分 类 号：R739.91[医药卫生—肿瘤]