快速组织扩张术在皮肤软组织缺损修复中的应用

Rapid tissue expansion for repairs of skin and soft tissue defects after injury

目的探讨采用皮肤快速扩张术修复创伤性皮肤软组织缺损的方法和效果。方法选择19例外伤性皮肤软组织缺损患者，共19个创面，择期埋置37个皮肤扩张器并进行快速扩张。术后第5天开始，隔日注水扩张1次，每次注水至有局部有轻度胀感。完成扩张后制作皮瓣，修复外伤性皮肤缺损创面，分Ⅲ期于术完成。结果37个扩张器全部完成注水扩张过程，注水扩张时间为46～63d。有5个扩张区出现并发症．但均得到控制。19个缺损创面均得到完整修复。6个月后随防12例，皮瓣色泽和质地与受区皮肤接近，外观良好，局部无臃肿。结论快速皮肤扩张术是修复某些特殊部位创伤性皮肤缺损的可行有效方法，可获得功能和美学双重修复的满意结果。

Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury. Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study, in which there were 19 wounds involved. Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model （one time every two days）. After completion of inflation, the expanded skin flaps were made and transferred to repair the wounds. Results All the 37 expanders were inflated successfully in duration of 46 63 days. Five expansion areas presented complications that were correct-ly controlled. All of the wounds were covered and healed well after the expanded skin flap transplanta tion. Twelve patients were followed up for 6 months after operation. The long-term results showed that tim color and texture of the flaps matched the recipient sites well without swelling. The aesthetic appearance of the repaired sites looked satisfactory. Conclusions The rapid tissue expansion is a bet ter option for repairs of some skin and soft tissue defects after injury in certain areas.