皮肤扩张器在头面部大面积皮肤病损治疗中的应用

Application of tissue expander in treatment of extensive head and faciocervical skin defects

目的:探讨皮肤扩张器在头面部大面积皮肤病损治疗中的临床应用。方法:使用皮肤扩张器治疗16例头面颈部大面积皮肤病损患者。选用100～500 ml容量的扩张器植入病损旁的皮下,注射壶内置,注水扩张6～8周。Ⅱ期手术取出扩张器,将扩张皮瓣用滑行推进或旋转推进方式修复切除病损之创面。结果:16例患者共治疗24处病损,置入扩张器39个,一次修复最大面积为12 cm×18 cm,所有患者均得到有效治疗;扩张期发生并发症2例,为术后血肿及扩张器外露,发生率约5%。结论:应用皮肤扩张器修复头面部大面积病损是一种理想的方法,但应重视并发症的预防。

faciocervical Objective： To evaluate the clinic application of tissue expander in treatment of extensive head and skin defects. Methods： Sixteen patients with head and faciocervical skin defects were treated by tissue expander. Expanders of 100 - 500 ml capacities were implanted under the normal skin of head and faciocervical area nearby the defects, with built-in injection pot, subsequent expansion was carried out for 6 to 8 weeks. Expanders were taken out and the expanded flaps were transferred through rotation, advancement or axial flap to the defects in a second surgery. Results： Twenty-four defects were effectively treated, with 39 expenders, in the 16 cases. The maximum proportion repaired in single treatment was 12cm - 18cm. Complications of hematoma and expender exposure were reported in 2 cases during the course of expending. Conclusion： The clinical application of tissue expander in treatment of treating extensive head and faciocervical skin defects shows great promise, though the complications should be concerned.