瘢痕性秃发的整复治疗

Plastic Repair of Cicatricial Alopecia

目的:总结瘢痕性秃发整复治疗的经验和教训,探讨针对不同秃发面积所做的相应修复方法的选择。方法:手术治疗瘢痕性秃发34例,其中秃发区分次切除缝合1例,秃发区切除局部皮瓣转移修复11例,头皮扩张术修复22例。结果:34例中完全修复30例、不完全修复4例。术后并发伤口裂开2例次、皮瓣坏死3例次、头皮血肿1例次、注射阀破损和扩张器漏水各2例次。术后随访29例,随访时间1～2a,头发生长的质地及外观均较满意。结论:较小面积的瘢痕性秃发可采用一次或分次切除后直接缝合,或加局部皮瓣转移修复;较大面积的秃发则需要采用头皮扩张术,以获得额外头皮瓣修复,方可获得满意的效果。

Objective:To summerize the clinical experience in plastic repair of cicatricial alopecia and to discuss the choice of repairing means according to the area of scar baldness.Methods:34 cases of cicatricial alopecia were treated by operation.One case was resected by stages,11 cases were resected and repaired with local normal scalp,and 22 cases were repaired with the scalp expanding technique.Results:Among the 34 cases,complete repaire was observed in 30 cases and incomplete repair in 4 cases.The complications included incision rupture in 2 cases,flap necrosis in 3 cases,scalp hematoma in 1 case,valve disrepair in 2 cases,and expander leaking in 2 cases.Hair growth and shape were excellent at 1～2 years follow-up in 29 cases.Conclusion:Small baldness area can be resected at one stage or by stages and can also be resected and repaired with local normal scalp,while the scalp expanding technique is implemented to obtain additional scalp to repair the lager baldness scar so as to achieve a satisfying outcome.