摘要
目的：研究持续恒压皮肤软组织扩张的手术方法及扩张期管理技术．方法：皮肤瘢痕患者２１例，在局部肿胀麻醉下经病变内垂直小切口埋植扩张器４５个，术后１ｄ～３ｄ开始进行持续恒压扩张（１０例）和持续恒速扩张（１１例），观察手术效果和患者对扩张的反应．结果：局部肿胀麻醉具有良好的止血作用，扩张器植入术可在无血条件下完成，手术时间少于常规方法．垂直切口有良好的抗张能力，术中可以向扩张器内大量注水，术后１ｄ～３ｄ即可进行持续注水扩张．扩张期根椐患者的反应调整灌注参数可避免血运障碍．采用这种改进的方法可使患者的住院时间显著缩短．结论：在局部肿胀麻醉下经垂直小切口埋植扩张器可以在术中大量注水和提前进行持续扩张，此法能最大限度地缩短患者的住院时间．
AIM:To study the surgical procedures for continuous tissue expansion and the management during expansion. METHODS: 21 patients with skin scar were employed in the study and 45 expanders were placed in the subcutaneous pocket through interlesional perpendicular short incisions under local tumescent anesthesia. Ten cases of continuous instant pressure expansion and eleven cases of instant speed expansion were carried out with two types of infusion pump at the first to third day after expander placement. Results and the reactions of patient to continuous expansion were assessed. RESULTS: Local tumescent anesthesia has been shown to decrease blood loss significantly and allowed expander placement under no blood surgical fields with less time. Intraoperative large volumes of might be injected and continuous expansion was carried out one to three days postoperation. Tissue blood obstruction was avoided when the infusing parameter was set by according to patient's reaction. The in admission time of patients was shortened significantly with the present technique. CONCLUSION: Expander placement through interlesional perpendicular incision allows of intra operative water injection and continuous expansion in advance. The clinical procedure maximally shortened patient′s in admission time.
出处
《第四军医大学学报》
1999年第11期991-993,共3页
Journal of the Fourth Military Medical University
关键词
组织扩张
肿胀麻醉
外科手术
tissue expansion
tumescent anesthesia
surgery,operation
