拉杆式皮肤扩展器在股前外侧皮瓣术后缺损中的应用  

The draw-bar skin stretcher used for repairing the wound area of the anterolateral thigh flap

作　　者：李晓光[1,2] 周杰玉[1,2] 刘凯 火子榕[1,2] 谭皓月[1,2] 何悦[3] 张治华[1,2] 王振涛 汪照炎[1,2] Li Xiaoguang;Zhou Jieyu;Liu Kai;Huo Zirong;Tan Haoyue;He Yue;Zhang Zhihua;Wang Zhentao;Wang Zhaoyan(Department of Otolaryngology-Head and Neck Surgery,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Ear Institute,Shanghai Jiao Tong University School of Medicine,Shanghai Key Lab,Shanghai 200125,China;Department of Oral Maxillofacial-Head and Neck Oncology,Shanghai Ninth People′s Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,200011 [2]上海交通大学医学院耳科学研究所上海市耳鼻疾病转化医学重点实验室,200125 [3]上海交通大学医学院附属第九人民医院口腔医学院口腔颌面头颈肿瘤科,200011

出　　处：《中华损伤与修复杂志（电子版）》2023年第2期144-147,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨拉杆式皮肤扩展器在游离股前外侧皮瓣术后缺损的临床应用效果。方法回顾性分析2020年1月至2021年1月上海交通大学医学院附属第九人民医院收治的30例患者,均行股前外侧皮瓣修复,供区创面均不能通过直接拉拢缝合,采用拉杆式皮肤扩展器进行皮肤扩张修复创面,术后观察创面愈合情况及相关并发症。结果30例患者均获得随访,随访时间5~12(8.5±3.5)个月。其中24例患者大腿供区创面顺利痊愈,局部无显著疤痕增生,下肢活动恢复正常。1例患者出现局部脂肪液化,5例患者出现张力性水泡及皮缘少量坏死,给予积极换药后创面愈合。结论应用拉杆式皮肤扩展器可治疗股前外侧皮瓣供区难以直接拉拢缝合的创面,可避免术中取皮植皮或转移局部组织瓣,减少二次损伤,术后供区肢体活动不受影响,但仍需严格掌握其适应症。Objective To explore the application value of draw-bar skin stretcher used for repairing the wound area of the anterolateral thigh flap.Methods Retrospective analysis was performed on 30 patients admitted to Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to January 2021,all of whom received anterolateral thigh flap repair.The donor site wounds could not be directly closed and sutured,and the wound healing and related complications were observed after using draw-bar skin stretcher.Results All 30 patients were followed up for 5-12 months,with an average of(8.5±3.5)months.Among them,24 patients recovered smoothly on the thigh donor site without significant local scar hyperplasia,and their lower limb activities returned to normal.Local fat liquefaction occurred in 1 patient,tension blister and a small amount of skin edge necrosis occurred in 5 patients.After active dressing change,the wound healed.Conclusion The draw-bar skin stretcher can be used to treat the wound that is difficult to be directly closed and sutured at the donor site of anterolateral thigh flap,avoid skin grafting or local tissue flap transfer during operation,and reduce secondary injury.The limb activity of the donor site is not affected after operation,but the indications should be strictly controlled.

关 键 词：皮肤牵张 股前外侧皮瓣 创面修复 

分 类 号：R622[医药卫生—整形外科]