应用整形理念修复严重皮肤缺损

Repairing serious skin damage by application of reshaping idea

目的探讨整形外科理念在治疗严重皮肤缺损中的应用作用。方法收集2004年1月～2006年12月间16例因车祸致双下肢皮肤缺损患者,均使用躯干部大张中厚完整自体皮移植修复关节部位创面,用头皮作为供皮区修复非关节部位创面的手术方法治疗严重皮肤缺损。观察治疗效果。结果16例患者创面均得到有效覆盖,皮片成活率在95%以上,关节部位的功能与外观得到良好恢复,无需二次手术治疗,因供皮而致的外观改变减少了40%～60%。结论治疗严重皮肤缺损时应用整形理念可达到以下三种目的:一是消灭创面;二是恢复关节功能及外观;三是尽可能减少了供皮所致的外观改变。

Objectives To explore the application of reshaping idea to treat patients with serious skin damage, which has achieved elimination of the injured area, restoration of the joint function and outward appearance and reducing appearance change after providing skin, so as to improve patients＇ quality of life. Methods According to different operations, all patients with serious skin damage were divided into treatment group（n = 16） and control group（n = 18）. The treatment group was treated by transplanting and repairing injured joint area with own torso big whole medium-thick skin and non-joint injured area with own scalp. The control group was treated by transplanting and repairing traditional small stanp skin-piece, with own torso skin. Results Two groups have obtained the effective cover. The survival ratio of two methods had no obvious difference. The treatment group obtained the effective cover on the injured area with the skin piece survival rate above 95% and good restoration of the joint function and the outward appearance, as well as reducing 40% -60% of appearance change from providing skin and no need second surgeries. The control groups did not obtain restoration of the joint function, and 83, 3% patients need the second surgeries after 3 to 6 months, the appearance change from providing skin had not reduced. Conclusions For serious skin damage, the treatment by application of reshaping idea can achieve three goals, which are to eliminate the injured area, restore the joint function and outward appearance and reduce as far as possible the outward appearance change from providing skin. This technique is deserved to be adopted and applied in clinic.