应用多孔聚乙烯耳支架并扩张筋膜皮瓣的耳廓再造

Porous polyethylene ear scaffold with expanded fascio-cutaneous flap for external ear reconstruction

耳廓再造在整形外科中难度较大,除再造耳的覆盖组织外,耳支架也十分重要,既要有一定强度以长期保持再造耳外形稳定不变,又要有一定的弹性。自体肋软骨一向是耳再造支架的首选材料,医用硅橡胶也曾一度有望成为自体肋软骨的替代品,但终因组织相容性欠佳现已甚少应用,多孔聚乙烯耳支架近两年已开始在国内应用,初步观察其组织相容性优于硅橡胶支架。因耳廓的覆盖组织菲薄,如采用假体构成支架其相容性要求较其他部位更高,否则极易排出。本文旨在比较几种耳廓再造支架材料的性能及生物相容性,为找到一种更适合的耳廓再造支架材料提供依据。

External ear reconstruction is difficult in orthopedic surgery. Besides the covering tissues, ear scaffold is also very important. It should have intensity to maintain the external appearance of the ear for a long-term, and have certain elasticity. Autogenous costal cartilage is a preferred material for external ear reconstruction. Medical grade silicon rubber is used to replace autogenous costal cartilage, but its application is limited due to bad histocompatibility. Porous polyethylene ear scaffold is applied in recently, and primary observation shows its histocompatibility is superior over medical grade silicon rubber. The covering tissue of the ear is very thin, so the histocompatibility of scaffold made of prosthesis is higher than other sites. This paper aimed to compare the performance and biocompatibility of several materials for external ear reconstruction to find a better material.