基于眶周形态及组织特点设计毛发移植治疗烧伤后眉缺损  

Treatment of eyebrow defects after burns with design of transplanted hair based on the orbital morphology and tissue texture

作　　者：蒋文杰 林俊青[2] 王博 刘晓娜 马颐宁 Jiang Wenjie;Lin Junqing;Wang Bo;Liu Xiaona;Ma Yining(Hair Transplantation Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China;Medical Cosmetic Center,Beijing Daxing District People’s Hospital,Beijing 102699,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毛发移植中心,北京100144 [2]北京市大兴区人民医院医学美容中心,北京102699

出　　处：《中华整形外科杂志》2024年第1期21-26,共6页Chinese Journal of Plastic Surgery

摘　　要：目的总结基于眶周形态及组织特点设计毛发移植治疗烧伤后眉缺损的经验。方法回顾性分析2011年1月至2023年9月于中国医学科学院整形外科医院毛发移植中心治疗的烧伤后眉缺损患者的临床资料。根据烧伤后患者眶周形态和组织特点对眉毛的位置和形态进行设计:以枕部靠近后发际线处或耳后发际处为供区, 使用头皮条切取法或毛囊单位切取术(FUE)获取毛囊, 有头皮瘢痕需要切除或曾行头皮扩张手术有"猫耳"畸形需要修整的头皮也可以作为供区, 将毛囊分为含单根毛发的毛囊单位(FUs);用规格为21或22 G针头在受区穿刺打孔直至皮下浅层, 然后用显微镊夹持毛干部, 将毛发移植到受区, 以修复眉毛形态。术后对患者眉毛密度、形态和方向以及供区瘢痕情况进行观察和随访。结果共纳入197例患者(282条眉毛), 其中男133例, 女64例;年龄9~62岁, 平均33.7岁;眉弓区皮片移植术后17例, 皮瓣及扩张皮瓣修复术后33例, 眼睑部皮片移植术后36例, 烧伤创面瘢痕愈合111例;双侧眉完全缺失51例、部分缺损34例, 单侧眉完全缺失65例、部分缺损47例。282条眉毛的植发量为53~600 FUs, 其中采用头皮条切取分离法75例, FUE法122例。术后随访9个月至10年, 有17例患者出现毛囊炎, 经75%乙醇涂擦后痊愈;9例眉毛密度不足, 1年后再次通过毛发移植进行加密;其余患者植入毛发生长良好, 接近正常眉毛的形态及方向, 效果满意。供区瘢痕不明显。结论采用毛发移植治疗烧伤后眉缺损时, 首先要根据眶周形态及组织特点设计眉形, 再考虑眉毛的整体位置和双侧的对称性。只有充分考虑烧伤后受区的特点, 才能获得理想的眉毛修复效果。Objective To summarize the experience of designing transplanted hair based on the orbital morphology and tissue characteristics for the treatment of eyebrow defects after burns.Methods A retrospective analysis was conducted on clinical data of the patients with eyebrow defects after burns who treated at Hair Transplantation Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences between January 2011 and September 2023.The location and appearance of eyebrow were designed according to the orbital morphology and tissue characteristics.The follicles were extracted by incision of scalps strips and follicle unit excision(FUE)on the donor area of the occipital region near the posterior hairline or the posterior ear hairline.Scalps with scars that needed to be removed or had"dog ear"deformities following scalp expansion surgery that needed to be repaired were also be used as donor sites.The follicles were divided as follicle units(FUs)including single hair.The recipient area was punched with syringe needle of 22 or 22 G to subcutaneous superficial layer.Then the hair shaft was clamped with microforceps and the hairs were transplanted to the defective area to restore the appearance of eyebrow.The density,morphology,direction and scars of the donor sites were observed by following-ups.Results A total of 197 patients with 282 eyebrows were recruited.There were 133 males and 64 females.The average age was 33.7(9 to 62)years.There were 17 patients with skin graft transplantation in the eyebrow arch,33 with flap and expanded flap repair,36 with eyelid skin grafting,111 with burn scar healing.A total of 51 patients had complete eyebrow defects on both sides,and 34 had partial defects.Sixty-five patients had complete eyebrow defects on single side,and 47 had partial defects.The amount of hair transplantation was from 53 to 600 FUs on 282 eyebrows.Seventy-five patients extracted follicles with incision of scalps strips and 122 with FUE.The patients were followed up for 9 months to 10 years.Folliculitis were found in 1

关 键 词：眉毛 毛发移植 毛囊 烧伤 

分 类 号：R622[医药卫生—整形外科]