面部皮肤软组织撕脱伤的超级显微外科修复效果探讨  

Clinical Effect of Supermicrosurgery Repair of the Avulsion of Facial Skin and Soft Tissue

作　　者：黎章灿 郑大伟 张旭阳 黄振 朱辉 石荣剑 宗亚力 周晓[2] LI Zhangcan;ZHENG Dawei;ZHANG Xuyang;HUANG Zhen;ZHU Hui;SHI Rongjian;ZONG Yali;ZHOU Xiao(Department of Microsurgery,Xuzhou Renci Hospital,Xuzhou 221004,Jiangsu,China;Department of Oncoplastic Surgery,Hunan Cancer Hospital,Changsha 410008,Hunan,China)

机构地区：[1]徐州仁慈医院显微修复重建外科,江苏徐州221004 [2]湖南省肿瘤医院肿瘤整形外科,湖南长沙410008

出　　处：《中国美容医学》2022年第10期4-7,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨应用超级显微外科技术治疗面部皮肤软组织撕脱伤的临床效果。方法:2018年1月-2020年1月笔者医院收治面部皮肤软组织撕脱伤22例,撕脱伤面积1.5 cm×6.0 cm~5.5 cm×11.0 cm,撕脱皮肤远端均有血运障碍;均运用超级显微外科技术吻合血管进行撕脱皮肤软组织的再植,术后予抗凝、解痉、预防感染治疗,门诊随访观察疗效。结果:本组22例撕脱皮肤均完成再植,吻合动脉16根,动脉外径平均0.6 mm(0.4~1.1 mm),吻合静脉25根,外径平均0.7 mm(0.4~1.2 mm)。术后发生皮瓣远端坏死1例,经换药后延期愈合;静脉危象3例,经切口放血后缓解;余撕脱组织顺利成活。经6~16个月随访,撕脱皮瓣成活良好、外观满意,伤口瘢痕不明显。结论:对于面部皮肤软组织撕脱伤,采用超级显微外科技术吻合血管再植,可提高撕脱组织成活率,获得面部功能和美学修复。Objective To investigate the clinical effect of supermicrosurgery in the treatment of the avulsion of facial skin and soft tissue.Methods From January 2018 to January 2020,22 cases of avulsion of facial skin and soft tissue were treated in our hospital.The avulsion area was 1.5 cm×6.0 cm-5.5 cm×11.0 cm.The blood circulation disorder was found in the distal part of avulsion skin.Supermicrosurgical technique was used to anastomose blood vessels for replantation of avulsed skin and soft tissue,and anticoagulation,antispasmodic and infection prevention were given after operation.The effect was observed in outpatient follow-up.Results The avulsion of skin was replanted in 22 cases,16 anastomosed arteries,with an average diameter of 0.6 mm(0.4-1.1 mm).25 anastomotic veins,the average outer diameter of 0.7 mm(0.4-1.2 mm).The flap necrosis occurred in one case after operation,delayed healing after drug change.3 cases of venous crisis,were relieved after bleeding through the incision.The remaining avulsed tissues survived successfully.After 6-16 months follow-up,the avulsion flap survived,the scar of the wound was not obvious,the function and appearance were good.Conclusion For the avulsion of facial skin and soft tissue,the supermicrosurgery technique can be used to anastomose the blood vessels,which can improve the survival rate of avulsed tissue and obtain the maximum function and aesthetic repair.

关 键 词：撕脱伤 面部 再植 超级显微外科 血管吻合 美学修复 

分 类 号：R622[医药卫生—整形外科]