多孔高密度聚乙烯支架在皮肤破溃感染的全耳廓再造术中的应用

Application of Medpor framework in total auricular reconstruction

目的对于先天性小耳患者，在应用扩张法行外耳再造术的过程中，当耳后皮肤软组织在扩张阶段发生扩张皮肤破溃，以致继发感染后，探索一种较为可行的外耳再造方法。方法对26例耳后扩张皮肤发生破溃感染的先天性小耳患者，经过积极的全身抗感染和适宜的局部换药处理，在感染得到有效控制后，应用多孔高密度聚乙烯（porous high density polyethylene，Medpor）材料做支架，外包蒂在前的耳后乳突区皮下组织筋膜瓣、扩张皮肤及移植皮片，行外耳再造术。结果26例外耳再造手术均获成功，耳形态令人满意，轮廓清晰。结论在耳后皮肤软组织扩张阶段，当扩张皮肤发生破溃继发感染后，用Medpor支架代替自体肋软骨支架行外耳再造术，是一种较为安全可行的手术方法。

Objective To seek a safer approach to auricular reconstruction when postauricular soft tissues ulcerate and are infected during expansion in the ease of congenital microtia. Method In 26 eases of congenital microtia, Medpor polyethylene framework was used as auricular framework covered by post- auricular facial flap pedicled in the front, in combination with the expanded skin flap and skin graft to replace usual autogenous costal cartilage in auricular reconstruction when the flap was infected during expansion. After effective control of infection through typical management and administration of antibiltics the reconstruction was initiated. Results All patients achieved success in auricular reconstruction. The reconstructed ears were well defined and the contour was satisfactory. Conclusions When the flap ulcerates and follows infection during expansion, it is safe and reliable to use Medpor framework in stead of autogenous costal cartilage in auricular reconstruction.