多个扩张器联合扩张修复大面积头皮瘢痕性秃发

Multiple expanders combined to expend for repairing defects of large scar alopecia

目的：探讨多个扩张器联合扩张修复大面积头皮瘢痕性秃发的效果.方法：2003年5月～2013年5月间,应用2～4个扩张器联合扩张的方法修复缺损面积为50 ～ 350cm2的头皮瘢痕性秃.手术分两期：Ⅰ期根据秃发面积的大小及部位,选择适当大小、形状及数量的扩张器,并在瘢痕周围置入扩张器注水扩张;Ⅱ期根据瘢痕切除术后的缺损情况进行滑行推进或旋转皮瓣修复.结果：80例头皮瘢痕性秃发,74例取得良好效果;3例秃发面积过大,一次扩张未能完全修复,经二次扩张修复后效果良好;1例出现切口感染而取出扩张器;2例出现Ⅱ期术后头皮血肿,经处理后愈合良好.随访5个月～5年,头皮头发生长良好,缝线处无明显瘢痕增生,头部外观有明显改善,患者对手术效果均比较满意.结论：应用多个扩张器联合扩张修复大面积头皮瘢痕性秃发,可以彻底切除瘢痕,使秃发部位有毛发覆盖,头部整体外观得到明显改善,是修复大面积瘢痕性秃发较为理想的一种方法.

Obstract：Objective To investigate the effects of the multiple expenders combined to expend for repairing defects of large scar alopecia.Methods From May 2003 to May 2013,2～4 expanders were used for repairing the defects of large scar alopecia size from 50cm2 to 350cm2.First stage,the appropriate expanders were chosen to implant into normal scalp around scar and injected for expantion.Second stage,the expanders were removed and sliding skin flaps or rotation skin flaps were made to repair the defects.Results 80 cases of scar alopecia,74 cases achieved good results;3 cases were too large to be fully repaired,the good results were achieved after second expantion; infection occurred in one case and removed the dilator;hematoma occurred in two cases,the wounds healed well after treatment.The follow-up for 5 months～5 years,the hair grown well to hide the scars,the significant improvement of appearance were got,the patients satisfied with the operation results.Conclusion Multiple expenders combined to expend for repairing defects of large scar alopecia can get good operation results,the scars can be excised drastically,the considerate improvements of appearance can be got,it is a ideal method of repairing large scar alopecia.