摘要
目的探讨应用扩张后头皮瓣修复额、面部黑痣、瘢痕切除后创面的临床效果。方法2014年5月至2019年5月,空军军医大学西京医院共收治先天性及后天性面额部病损患者28例,男12例,女16例,年龄3~42岁。其中额部黑痣5例、额部瘢痕11例、面部黑痣2例、面部瘢痕9例、面部疣状痣1例,均采用扩张后头皮瓣修复。根据病变大小选择合适扩张器,扩张囊置入帽状腱膜下,注水充分扩张后,采用直接推进或易位皮瓣修复病损切除后创面,带蒂皮瓣以颞浅动脉分支为轴心血管,3周后断蒂,拆线后2周行激光脱毛3~6次。结果本组28例,扩张一期均充分,二期皮瓣转移术后全部成活,无感染、局部坏死等发生。皮瓣断蒂后2例出现远端小面积血运障碍,予植皮覆盖后愈合。随访时间3~31个月,转移的皮瓣经激光脱毛后,颜色、质地与相邻部位正常皮肤匹配良好,无挛缩及色素沉着发生,效果满意。结论头皮组织量充足,继发畸形少,是良好的供区。扩张后头皮瓣修复额、面部病损,皮瓣血供好,术后结合激光脱毛,效果良好。
Objective To explore the clinical effect of expanded scalp flaps in repconstructing the wounds after resection of frontal and facial nevus and scar.Methods From May 2014 to May 2019,28 patients(5 cases of nevus and 11 cases of scar in the frontal part and 2 cases of nevus,9 cases of scar and 1 case of verrucous nevus in facial part)were repaired with expanded scalp flaps.According to the size of the lesion,the expander was selected and placed under the galea aponeurotica.After tissue expansion,the wound was reconstructed by random designed or pedicled skin flaps.The pedicled skin flaps took the branch of superficial temporal artery as the pedicle.The pedicle was cut off after 3 weeks.Hair removal by laser was performed 3 to 6 times 2 weeks after removing the suture.Results In all the 28 cases,expansion in the first stage was sufficient,after skin flap transfer in the second stage,all survived without infection or local necrosis.After the pedicle division,2 cases had small area of distal blood flow disorder,and the wound was healed after skin grafting The follow-up time ranged from 3 to 31 months.After hair removal by laser,the color and texture matched well with the normal skin in the adjacent area.No contracture and pigmentation occurred,and the effect was satisfactory.Conclusions The scalp is a good donor site for expansion with sufficient tissue and few secondary deformities.The expanded scalp flap has good blood supply for repairing frontal and facial lesions,after hair removal by laser,the effect is good,and it is worth popularizing and applying.
作者
刘士强
唐银科
楚菲菲
王占统
董琛
陈淑强
马显杰
Liu Shiqiang;Tang Yinke;Chu Feifei;Wang Zhantong;Dong Chen;Chen Shuqiang;Ma Xianjie(Department of Plastic and Reconstructive Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第7期776-779,共4页
Chinese Journal of Plastic Surgery
基金
国家自然科学基金(81671925)
陕西省科技项目(2018ZDXM-SF-081)。
关键词
扩张器
头皮
额面部病损
修复重建
Tissue expander
Scalp
Frontal and facial lesions
Reconstruction
