耳廓不完全撕脱伤即刻修复体会  

Experience of Imediate Repair of Incomplete Ear Amputation

作　　者：周林[1] 王瑞[1] 舒茂国[1] 郭媛[1] ZHOU Lin;WANG Rui;SHU Maoguo;GUO Yuan(Department of Aesthetic Plastic and Craniofacial Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院整形美容颌面外科,陕西西安710061

出　　处：《中国美容医学》2023年第7期40-43,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨耳廓不完全撕脱伤的即刻修复的临床疗效。方法:选取2016年2月-2021年5月笔者医院的27例耳廓不完全撕脱伤患者,根据耳廓撕脱伤情况选择合适的即刻修复方法,包括直接缝合、植皮或局部皮瓣。耳廓不完全撕脱伤患者共27例,男17例,女10例。年龄8~55岁,平均年龄31岁。受伤到手术清创的时间为1~12 h,平均时间为3.5 h,其中清创后直接缝合15例,全厚皮片移植修复6例,局部皮瓣转移修复6例。结果:所有直接缝合的耳廓外伤均一期愈合,2例植皮术后出现部分皮片坏死,经换药处理后创面愈合,1例一期关闭创面,术后半年后取肋软骨支架行颞肌筋膜瓣+植皮修复,其余皮瓣均成活良好。术后随访6~18个月,耳廓外形恢复良好,瘢痕隐蔽,无明显挛缩。结论:耳廓不完全撕脱伤需根据撕脱的部位、大小及形状,选择合适的修复方案,尽可能达到即刻修复,恢复正常的外形及功能,获得满意的美学修复效果。Objective To investigate the clinical effect of immediate repair of incomplete auricle avulsion.Methods From February 2016 to May 2021,27 patients with incomplete auricle avulsion injury in the author’s hospital were selected,appropriate immediate repair methods according to the avulsion injury of the auricle,including direct suture,skin grafting or local flaps.There were 27 cases with incomplete auricle avulsion injury,including 17 males and 10 females.The age ranged from 8 to 55 years,with an average age of 31 years.The time from injury to surgical debridement was 1-12 hours,with an average of 3.5 hours,including 15 cases of direct suture after debridement,6 cases of full-thickness skin graft repair,and 6 cases of local flap transfer repair.Results All directly sutured auricle wounds healed in one stage.In 2 cases,partial skin necrosis occurred after skin grafting,and the wound healed after dressing change.In 1 case,the wound was closed in one stage.Half a year after surgery,the costal cartilage scaff old was taken to repair temporalis muscle fascia flap and skin grafting,and the remaining flaps survived well.After 6-18 months of follow-up,the shape of the auricle recovered well,the scar was hidden,and there was no obvious contracture.Conclusion According to the location,size and shape of auricle avulsion,appropriate repair plan should be selected to achieve immediate repair,restore normal appearance and function,and obtain satisfactory aesthetic repair results.

关 键 词：耳廓 撕脱伤 即刻修复 耳重建 外科手术 

分 类 号：R764.91[医药卫生—耳鼻咽喉科]