皮肤软组织扩张术在儿童颈胸部增生性瘢痕修复中的应用  

Application of skin and soft tissue expansion in the repair of hypertrophic scar in children's neck and chest

作　　者：徐培 张红玲 童欢 龙忠恒 张祥明 XU Pei;ZHANG Hongling;TONG Huan;LONG Zhongheng;ZHA NG Xiangming(Department of Skin Wound Repair Center,Tongren Hospial of Wuhan University&Wuhan Thind Hospital,Wuhan 430070,China)

机构地区：[1]武汉大学同仁医院暨武汉市第三医院皮肤创面修复中心,湖北武汉430070 [2]武汉大学同仁医院暨武汉市第三医院中医科,湖北武汉430070

出　　处：《中国美容整形外科杂志》2024年第3期153-156,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨应用皮肤软组织扩张术修复儿童颈胸部增生性瘢痕的临床效果。方法 回顾性分析自2015年1月至2021年12月,武汉大学同仁医院暨武汉市第三医院皮肤创面修复中心收治的6例颈胸部增生性瘢痕患儿。一期行皮肤软组织扩张器置入术,在颈胸部瘢痕侧方正常皮肤置入扩张器,术后注水扩张3个月左右,扩张充分后静置维持2周。二期行扩张皮瓣修复术,取出扩张器,切除颈胸部增生性瘢痕,将扩张皮瓣向胸部方向推进修复创面。术后观察皮瓣成活情况,各期手术后的并发症情况。采用电话访谈、门诊复查等方式定期随访,观察瘢痕增生情况及术后患儿及家属满意度。结果 6例患儿扩张器置入术后无感染发生,无扩张器外露,皮瓣成活良好,无切口裂开发生。所有患儿扩张皮瓣修复术后随访1~5年,患儿颈胸部瘢痕增生不明显,部分患儿遗留扁平瘢痕,疼痛、瘙痒症状明显改善,患儿及家属满意度较高。结论 采用皮肤软组织扩张术修复儿童颈胸部增生性瘢痕,安全可靠,效果显著。瘢痕侧方正常皮肤是设计随意型扩张皮瓣的首选位置。Objective To investigate the clinical effect of skin and soft tissue expansion to repair hyperplastic scar in children's neck and chest.Methods A retrospective analysis was performed on 6 cases of children with cervicothoracic hypertrophic scar admitted to Department of Skin Wound Repair Center,Tongren Hospital of Wuhan University&Wuhan Third Hospital from January 2015 to December 2021.The skin and soft tissue dilator was implanted into the normal skin on the scar side of the neck and chest in the first stage.The dilator was dilated by water injection for about 3 months after the operation,and remained for 2 weeks after the dilation was sufficient.In the second stage,the expanded skin flap was repaired.The dilator was removed,the hyperplastic scar was removed,and the expanded skin flap was pushed toward the chest to repair the wound.The survival of the flap and the complications of each stage of operation were observed.Regular follow-up was conducted by telephone interview and outpatient review to observe scar hyperplasia and postoperative satisfaction of the children and their families.Results There was no infection occurred,no dilator was exposed,the skin flap survived well,and no incision split occurred in 6 patients after dilator implantation.All the children were followed up for 1 to 5 years after the extended flap repair,and the scar hyperplasia of the neck and chest of the children was not obvious,some of the children left flat scars,and the symptoms of pain and itching were significantly improved,and the children and their families were highly satisfied.Conclusion It is safe,reliable and effective to use skin and soft tissue dilation to repair hyperplastic scar in children's neck and chest.The normal skin on the side of scar is the preferred location for the design of arbitrarily expanded flaps.

关 键 词：增生性瘢痕 软组织扩张术 扩张皮瓣 儿童 烧伤 修复 

分 类 号：R726[医药卫生—儿科]