钛丝-可吸收缝线双线联合牢固拼接技术用于先天性小耳畸形耳廓再造术肋软骨支架成型的效果分析  

Effect analysis of titanium wire-absorbable suture dual line combined firm stitching technique in costal cartilage framework shaping for congenital microtia auricular reconstruction

作　　者：屈见闻 贾阳 孔震 张春莉[3] 林琳 潘博 李川 Qu Jianwen;Jia Yang;Kong Zhen;Zhang Chunli;Lin Lin;Pan Bo;Li Chuan(Department of Auricular Reconstruction,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China;Department of Plastic Surgery,Shenzhen People's Hospital,Shenzhen 518020,China;Department of Plastic Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]中国医学科学院、北京协和医学院、整形外科医院外耳整形再造科,北京100144 [2]深圳市人民医院整形美容外科,深圳518020 [3]河北医科大学第二医院整形外科,石家庄050000

出　　处：《中华医学美学美容杂志》2025年第1期30-35,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：中国医学科学院整形医学研究专项(2024-ZX-2-03)。

摘　　要：目的:探讨钛丝-可吸收缝线双线联合牢固拼接技术在先天性小耳畸形耳廓再造术肋软骨支架成型中的应用效果。方法:回顾性纳入2020年1月至2021年12月中国医学科学院北京协和医学院整形外科医院行耳廓再造术的120例先天性小耳畸形患者,其中男86例,女34例,年龄6~15(8.5±2.1)岁。所有患者均接受扩张皮瓣法耳廓再造术,采用钛丝-可吸收缝线双线联合牢固拼接技术构建自体肋软骨多层立体耳支架。术后随访1~3年,评估再造耳廓的形态、稳定性、患者满意度和不良反应发生情况。结果:120例患者中,119例(99.2%)患者均达到一期愈合,再造耳廓形态逼真,亚结构清晰,远期再造耳形态能够保持稳定,未见明显变形。另外1例患者因局部皮肤感染破溃导致软骨支架外露,采用颞顶筋膜瓣转移和游离植皮成功修复。85.8%(103/120)的患者对术后效果感到满意,13.3%(16/120)的患者认为一般,0.8%(1/120)的患者感到不满意。所有患者均未发生血肿及皮瓣坏死。结论:采用钛丝-可吸收缝线双线联合牢固拼接技术构建的肋软骨支架在耳廓再造术中具有良好的临床应用效果,未发生严重不良反应。Objective To investigate the effect of titanium wire-absorbable suture dual line combined firm stitching technique in costal cartilage framework shaping for auricular reconstruction in congenital microtia patients.Methods A retrospective study was conducted on 120 patients with congenital microtia who underwent auricular reconstruction surgery at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from January 2020 to December 2021.Among these,86 were male and 34 were female,with an age range of 6-15(8.5±2.1)years.All patients underwent auricular reconstruction using the expanded skin flap method,and the titanium wire-absorbable suture dual line combined firm stitching technique was used to construct a multi-layer three-dimensional autologous costal cartilage framework.Postoperative follow-up was conducted for 1 to 3 years to evaluate the morphology,stability,patient satisfaction,and occurrence of adverse reactions.Results Of the 120 patients,119(99.2%)achieved primary healing.The reconstructed auricles were lifelike with clear substructures,and the long-term shape of the auricles remained stable without significant deformation.One patient developed a local skin infection and ulceration,leading to exposure of the cartilage framework,which was successfully repaired using a temporal fascia flap and free skin graft.A total of 85.8%(103/120)of the patients were satisfied with the postoperative results,13.3%(16/120)rated the outcome as average,and 0.8%(1/120)were dissatisfied.No cases of hematoma or flap necrosis were observed in any of the patients.Conclusion The costal cartilage framework,constructed using the titanium wire-absorbable suture dual line combined firm stitching technique,demonstrates good clinical effects for auricular reconstruction with no severe adverse reactions.

关 键 词：先天性小耳畸形 钛丝 可吸收缝线 肋软骨支架 耳廓再造术 

分 类 号：R76[医药卫生—耳鼻咽喉科]