头皮缺损15例修复方式的选择与探讨

THE CHOICE OF THE WAYS OF 15 SCALP DEFECT REPAIR AND DISCUSSION

目的:探讨分析头皮缺损的修复方式及临床疗效。方法:回顾性分析我院于2010-09～2012-12收治的15例接受手术治疗的头皮缺损患者的临床资料,其中6例患者接受局部头皮瓣移植修复,6例接受游离皮瓣移植修复,3例接受头皮扩张。对各类修复方式手术次数,手术涉及的头皮下深度及手术效果进行观察比较。结果:接受局部头皮瓣移植修复的6例患者中,术后1例患者术后发生皮瓣下血肿,手术治疗后恢复良好,所有患者均出现不同程度的瘢痕性秃发。接受游离皮瓣移植修复的患者术后皮瓣血运均良好,但存在皮瓣臃肿及秃发的现象。接受头皮扩张的患者中有1例患者于术后发生扩张器周围脓肿,1例发生皮瓣下血肿,手术治疗后恢复良好。其余患者皮瓣血运良好,且术后头部外观良好。结论:局部头皮瓣与游离皮瓣用于修复头皮缺损,术后皮瓣血供较好,但美观效果不佳,头皮扩张术能够达到较好的美观效果,但手术过程中应注意并发症的发生。

Objective: to investigate the scalp defect,repair methods and clinical curative effect.Methods: A retrospective analysis of the clinical data of scalp defect patients in 2010 September-December 2012,of 15 patients who underwent surgical treatment,6 patients accepted local flap grafting to repair,6 cases accepted free flap transplantation to repair,3 cases of scalp expansion.Mode of of all kinds of repair surgery,involving the scalp of depth and compared to observe surgery effect.Results: accept local head skin flap transplantation to repair of 6 cases of postoperative hematoma,1 patients postoperative flap recovering well After surgery,all patients showed different degrees of cicatricial alopecia.the patients undergoing free flap transplantation to repair surgery flap blood supply are good,but there are flap bloated and bald.Treated with scalp expansion in 1 patient postoperative dilator surroundings abscess,1 case occurred under the flap hematoma,recovering well after surgery.Patients with the rest of the skin flap blood supply is good,and the postoperative appearance of the head is good.Conclusion: Local head skin flap and free flap to repair scalp defect,postoperative flap show good blood supply,but beautiful,scalp dilatation can achieve better aesthetic effect,but the operation should be paid attention to in the process of complications.