皮瓣联合单层型人工真皮技术修复颅骨钛网外露的临床疗效观察  

Clinical Efficacy Evaluation of Flap Transfer Combined with Single-layer Artificial Dermis in Repair of Skull Titanium Mesh Exposure

作　　者：黄华旭 刘立强 谢包根 陈健[1] 翁明生 徐志雄 卢政 李瑞粦 黄永新[1] HUANG Huaxu;LIU Liqiang;XIE Baogen;CHEN Jian;WENG Mingsheng;XU Zhixiong;LU Zheng;LI Ruilin;HUANG Yongxin(Department of Burn and Plastic Surgery,the First Hospital of Putian,Teaching Hospital,Fujian Medical University,Putian 351100,Fujian,China;Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China)

机构地区：[1]福建医科大学莆田市第一医院教学医院烧伤整形科,福建莆田351100 [2]中国医学科学院北京协和医学院整形外科医院,北京100144

出　　处：《中国美容医学》2025年第4期51-54,共4页Chinese Journal of Aesthetic Medicine

基　　金：莆田学院校级科研立项(编号:2022091)。

摘　　要：目的:探讨基于皮瓣联合单层型人工真皮技术修复颅骨钛网外露的临床效果。方法:选取2015年6月-2023年6月笔者医院收治的11例颅骨钛网外露患者为研究对象,通过皮瓣联合单层型人工真皮技术对缺损直径大于3 cm的颅骨钛网外露患者进行创面修复,于邻近钛网覆盖区域外分离并形成血运良好的局部皮瓣或前期置入的扩张器取出后形成的扩张皮瓣,予旋转、转移至覆盖单层人工真皮的钛网表面进行修复,覆盖不足处可予单层人工真皮上移植中厚自体皮片,对创面进行一次性修复。供瓣区创面较小的直接拉拢缝合,较大的予自体皮移植修复。结果:本组11例患者共13处创面,全部达到一期愈合。供瓣区愈合良好,随访6个月~4年,无复发,供受区皮肤平整、外观未显现置入钛网网格状纹路,未见明显瘢痕增生。其中1例于人工真皮表面植皮患者,皮片存活良好,切口愈合佳,随访未发现明显皮片坏死。手术前后CT或MRI复查提示:人工真皮覆盖后皮瓣厚度比同一皮瓣邻近组织增厚约2 mm,填充处无腔隙形成。结论:局部皮瓣联合单层型人工真皮修复颅骨钛网外露患者效果良好,值得临床推广应用。Objective To investigate the clinical efficacy evaluation of flap transfer combined with single-layer artificial dermis in repairing skull titanium mesh exposure.Methods Eleven patients with skull titanium mesh exposure admitted to the author's hospital from June 2015 to June 2023 were selected as the research objects.Patients with exposed skull titanium mesh with defect diameter greater than 3 cm were repaired by skin flap combined with single-layer artificial dermis technique.Local skin flaps with good blood transport were separated outside the area covered by titanium mesh or expanded skin flaps formed after removal by previously implanted dilators were rotated and transferred to the titanium mesh surface covered by single-layer artificial dermis for repair.A single layer of artificial dermis can be grafted with medium thickness autologous skin to repair the wound at one time.The smaller wound in the donor flap area was directly drawn and sutured,and the larger wound was repaired by autologous skin transplantation.Results There were 13 wounds in 11 patients in this group,and all of them achieved primary healing.The donor sites of flaps healed well,and there was no recurrence during follow-up of 6 months to 4 years.The skin of the donor and recipient sites was smooth,and there was no grid-like pattern of titanium mesh placement in appearance,and no obvious scar hyperplasia was observed.The skin graft on artificial dermis survived well and the incision healed well in 1 patient,and no obvious skin graft necrosis was found during follow-up.Preoperative and postoperative CT or MRI reexamination showed that the thickness of the flap after artificial dermis coverage was about 2 mm thicker than the adjacent tissue of the same flap,and there was no cavity formation at the filling site.Conclusion Flap transfer combined with single-layer artificial dermis is effective in repairing the exposed titanium mesh of skull and is worthy of clinical application.

关 键 词：皮瓣 单层型人工真皮 修复 颅骨 创面 钛网外露 一期愈合 

分 类 号：R622[医药卫生—整形外科]