头面部皮肤恶性肿瘤及癌前病变手术切除和创面修复的方法探讨  

Surgical Resection and Wound Repair for Cutaneous and Malignant Precancerous Lesions of the Head and Face

作　　者：赵亚楠[1] 康晓静[1] 于世荣[1] 安彩霞[1] 罗东[1] 张景展 ZHAO Ya-nan;KANG Xiao-jing;YU Shi-rong;AN Cai-xia;LUO Dong;ZHANG Jing-zhan(Department of Dermatology,the Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830001,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院皮肤性病科,新疆乌鲁木齐830001

出　　处：《中国美容医学》2018年第12期28-31,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨头面部皮肤恶性肿瘤及癌前病变手术切除和创面修复的方法。方法:58例头面部恶性肿瘤及癌前病变患者,根据恶性肿瘤手术原则,彻底切除病灶,应用原位缝合9例,游离皮片18例,局部皮瓣31例的方法进行修复。结果:本组58例,除1例皮片移植表皮部分坏死,经换药治疗伤口二期愈合外,其余植皮及皮瓣均一期修复,供区均一期愈合,颜面部外观满意。完成随访的42例中,1例面部鳞癌经局部皮瓣修复术后1年复发,再次扩大切除行皮片移植术后随访3年未见复发,其余41例均未见复发。结论:对于头面部恶性肿瘤及癌前病变应早期诊断,依据恶性肿瘤的治疗原则彻底切除病灶,术中快速冰冻切片可降低复发率,修复缺损应最大程度兼顾缺损区域功能和外形。Objective To investigate the methods of resection and wound repair of skin malignant tumor and precancerous lesions in the head and face.Methods There were58patients with head and face malignant tumors and precancerous lesions,according to the principle of malignant tumor surgery,the focus were thorough excision,9cases were repaired with orthotopic suture,18cases with free skin grafting and31cases with local skin flap.Results All the cases in this group were primary repair and primary healing,except for one case of which the skin grafting surface was partly necrosis,and healed in secondary.Among42cases with foIlow up,one case of facial squamous cell carcinoma recurred1year after local skin flap repair,no recurrence was found in3years of follow-up after extended resection and skin graft,and no recurrence was found in the remaining41cases.Conclusion For head and face malignant tumors and precancerous lesions,it should be early diagnosed and completely resected according to the treatment principle of malignant tumors.Rapid frozen section during surgery can reduce the recurrence rate,and the function and shape of the defect area should be taken into account to the greatest extent for the repair of defects.

关 键 词：创面修复 恶性肿瘤 癌前病变 头面部 皮瓣 植皮修复 手术切除 

分 类 号：R622[医药卫生—整形外科]