会阴瘢痕挛缩的整形外科修复  

Management of perineal scar contracture with principles of plastic surgery

作　　者：冯隽 杨喆 陈文 马宁 王维新 许砾思 刘启宇 陈森 李养群 Feng Jun;Yang Zhe;Chen Wen;Ma Ning;Wang Weixin;Xu Lisi;Liu Qiyu;Chen Sen;Li Yangqun(The Second Deparment of Plastic Suregery,Plastic Surgery Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100144,China;Department of Plastic Surgery,Peking University Shenzhen Hospital,Shenzhen 518036,China)

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二科,100144 [2]北京大学深圳医院整形外科,518036

出　　处：《中华整形外科杂志》2021年第11期1222-1226,共5页Chinese Journal of Plastic Surgery

基　　金：北京市科委首都特色重大项目(Z161100000516015)。

摘　　要：目的探讨会阴部瘢痕挛缩畸形的临床表现形式及整形外科治疗原则。方法选择2000年1月1日至2018年12月31日,中国医学科学院北京协和医学院整形外科医院收治的会阴畸形患者,以瘢痕松解、创面覆盖和器官缺损修复为目的,采用组织扩张技术、阴茎延长术、阴茎再造术及肛门成形术等多种手术方法修复。术后随访观察排尿、排便及关节活动等功能改善情况;评估会阴形态及术区瘢痕恢复情况。结果16例患者纳入该研究,年龄13~44岁,获1~10年面诊随访,12例术后无并发症,4例出现部分皮瓣存活不良,经换药后创面愈合,术后均可自主生活、自主排尿及排便,会阴畸形明显改善。结论会阴瘢痕挛缩的治疗遵循整形外科分区修复的原则,综合运用多种整形外科手术方法及时治疗,可获得较好的效果,明显改善患者的生活状态及质量。Objective To investigate the clinical manifestation and the plastic surgery principles of perineal scar contracture deformity.Methods Patients with perineal deformities admitted to Plastic Surgery Hospital,Chinese Academy of Medical Sciences,were enrolled from January 1,2010 to December 31,2018.For the purpose of scar release,wound coverage,and organ defect reconstruction,we applied multiple plastic surgery methods such as tissue expansion techniques,penile lengthening,penile reconstruction,and anoplasty.Patients were followed-up for at least 6 months after operations.Urinary function,defecation function,range of joint motion,the appearance of perineum and the scar of the operation site were evaluated.Results 16 cases,aged 13 to 44 years old,were enrolled in our study and were successfully followed up for 1 to 10 years.There were no postoperative complications in 12 patients,and poor survival of partial flaps was shown in 4 patients,and the wound healed after dress-changing.Satisfactory results were obtained as self-maintenance,self-controllable urination,and defecation were restored.Conclusions Following principles of subarea reconstruction in plastic surgery and using multiple plastic surgery methods,satisfactory results can be obtained in the repair of perineal scar contracture,which highly improves the life qualities of patients.

关 键 词：会阴畸形 瘢痕挛缩 阴茎延长术 阴茎再造术 

分 类 号：R713.22[医药卫生—妇产科学]