两次延迟在扩张皮瓣转移中的临床应用

Twice delaying of the expanded flap

目的 介绍一种在扩张皮瓣转移过程中增加扩张皮瓣成活面积的两次延迟法。方法在扩张器注水充分后 ,分两次行延迟术。首先据情在扩张皮瓣设计两条平行切口线 ,切开皮肤、皮下组织达扩张器包膜表面 ,原位缝合。术后 10～ 14d行第 2次延迟术 ,在扩张皮瓣远端设计弧形切口 ,与第 1次延迟术切口相连。切开达扩张器包膜表面 ,缝合切口。第 2次延迟术后 10～ 14d切取扩张皮瓣转移修复创面。结果 自 2 0 0 0年 8月至 2 0 0 2年 8月 ,应用本法为 16例长宽比值过大 (扩张皮瓣最大面积为 36cm× 9cm ,长宽比例为 4∶1)或旋转转移角度过大的扩张皮瓣行两次延迟术 ,术后皮瓣未见血运障碍 ,10 0 %成活。结论 两次延迟在扩张皮瓣转移中能保障皮瓣的血运 ,并明显提高了扩张皮瓣成活的面积。

Objective To introduce a new method for enlarging the survival area of an expanded flap. Methods After the skin expander was inflated with enough injection,the first delaying was performed.In the operation,two incisions were made in the skin and subcutaneous tissue superficial to the expander capsule on both sides of the long axis of the expanded flap.After 10 to 14 days,the second delaying followed,in which one pedicle was divided to form a unilateral |pedicled,super |long random flap.When the flap was transfered to the recipient area,the door site was closed directly. Results Since 2000,this technique has been used in 16 patients.All the flaps survived completely. Conclusions The technique of twice delaying can enlarge the survival area of the expanded skin flap. ;