摘要
目的总结应用V形切口切除头皮下肿物的临床经验。方法回顾性分析2020年8月至2021年12月北部战区总医院烧伤整形科收治的头皮下良性肿物患者的临床资料,肿物直径均大于3 cm且与周围组织粘连紧密,均应用V形切口切除肿物。术中沿设计线切开头皮、掀起V形皮瓣并完整切除肿物,自切口尖端逐针缝合至张力适中位置,将头皮瓣平铺于创面上,切除多余的头皮组织并缝合,形成Y形切口。术后对皮瓣成活、并发症、切口瘢痕、切口周围头发生长及肿物复发情况进行观察和随访。结果共纳入20例患者,其中男12例,女8例;年龄(46.8±10.5)岁;病史(3.6±1.9)年;肿物直径(4.1±1.1) cm;皮脂腺囊肿8例,脂肪瘤5例,表皮样囊肿7例。术后18例皮瓣成活良好,2例皮瓣尖端表皮坏死,经换药后愈合。术后随访6~12个月,3例患者局部头皮感觉麻木,3~6个月好转;20例术区头皮平整,切口瘢痕无明显增生,视觉上瘢痕短,周围头发生长正常,肿物均无复发。结论 V形切口显露肿物相对容易,可以精确切除多余皮肤,术后头皮平整度及外观较好,是与周围组织粘连紧密、剥离困难的较大头皮下肿物较好的切口选择。
Objective To summarize the clinical experience of using V-shaped incision to excise scalp subcutaneous tumors.Methods A retrospective analysis of the clinical data of patients with subcutaneous benign tumors admitted to the Department of Burns and Plastic Surgery of the Northern Theater General Hospital from August 2020 to December 2021 was conducted.The tumors were all above 3 cm in diameter and closely adhered to surrounding tissues,and all were removed using a V-shaped incision.During the operation,the scalp was incised along the design line,the V-shaped skin flap was lifted to affiliate the tumor removed.The incision was closed directly from the tip of"V"until the moderate tension attained.The scalp flap was spread smoothly on the wound surface,and the excess scalp tissue was removed to form a Y-shaped suture.The flap survival,complications,incision scar,hair growth around the incision and tumor recurrence were observed and followed up after operation.Results A total of 20 cases were included,including 12 males and 8 females,with an average medical history of(3.6±1.9)years and a tumor diameter of(4.1±1.1)cm.There were 8 sebaceous cysts,5 lipomas,and 7 epidermoid cysts.After operation,18 flaps survived well,and 2 cases had epidermal necrosis at the tip of the flap,which healed after dressing change.During the follow-up period of 6-12 months,3 patients experienced local scalp numbness,which improved within 3-6 months.In 20 cases,the scalp was flat,the incision scar was not hyperplastic,the scar was short visually,the surrounding hair grew normally,and no tumor recurrence happened.Conclusion V-shaped incision is relatively easy to expose the tumor and can accurately remove excess skin.After operation,the scalp has a good flat appearance,so it is an ideal choice for large scalp subcutaneous tumors with close adhesion to the surrounding tissue.
作者
孙海玮
林枫
郝春雨
王安娜
王洪一
Sun Haiwei;Lin Feng;Hao Chunyu;Wang Anna;Wang Hongyi(Department of Burns and Plastic Surgery,the Northern Theater General Hospital,Shenyang 110016,China)
出处
《中华整形外科杂志》
CSCD
2023年第5期535-539,共5页
Chinese Journal of Plastic Surgery
基金
国家科学自然基金青年科学基金项目(82002047)。
关键词
修复外科手术
头皮下肿物
V形切口
直线切口
S形切口
Reconstructive surgical procedures
Scalp subcutaneous tumors
V-shaped incision
Linear incision
S-shaped incision
