应用超量扩张术修复大面积面颈部瘢痕

Application of skin soft tissue expansion with enlarged solution volume for repair of large facial and neck scar

目的:探讨延长扩张时间、增大扩张量的皮肤软组织扩张术的临床效果。方法:应用皮肤软组织扩张术修复面颈部瘢痕切除后创面25例,手术分两期进行,Ⅰ期手术:在需要修复的瘢痕组织临近的正常皮肤上设计埋置扩张器的大小、形状及埋置方式,扩张器容量为100～400ml,扩张时间为3～6个月,扩张量为额定容量的2～5倍;Ⅱ期手术:取出扩张器,切除瘢痕,利用扩张皮瓣转移修复创面。结果:全部病例均获得满意效果,随访3个月至10年,皮瓣平整,外观色泽、质地均佳。结论:延长扩张时间,增加扩张量可以产生更多的额外皮肤,修复大面积面颈部瘢痕效果良好。

Objective To explore the effect of skin expansion with prolonged injected time and increased injected solution volume. Methods Skin soft tissue expansion has been used to repair skin defect from facial and neck scar in 25 patients. Skin soft tissue expansion technique included two stage-operation. We decided the size, shape of the expander and the way of implantation according to the lesion in the first stage-operation. The expanders of 100 to 400ml were implanted under the skin and expanded for 3 to 6 months. At the end of the expansion, the injected solution volume was 2 to 5 times of the volume of the expander. The expander was removed, the scar was excision and the expanded skin flaps were transferred to repair the defect in the second stage-operation. Results All cases were followed up for 3 months to 10 years, the results were satisfactory. The flaps survived with excellent appearance, color and texture, Conclusion The skin expansion with prolonged injected time and increased injected solution volume can produce more skin tissue than the routine expansion. We think that it is an effective method to repair of the large facial and neck scar.