扩张皮瓣整复颈部瘢痕挛缩的技巧与美学问题

OPERATIVE TECHNIQUE AND AESTHETIC PROBLEM OF USING EXPANDED SKIN FLAP TO REPAIR CICATRICIAL CONTRACTURE OF NECK

目的 :探讨采用扩张皮瓣整复颈部瘢痕挛缩的技巧与相关的美学问题。 方法 :根据颈部瘢痕的部位、范围和病灶周围情况选择扩张器的数量、容量与埋植部位 ;注水过程中采用扩张器托以防止其移位 ;用改良的下颌部软组织瓣重建颏部与下颌缘并加深颌颈角 ;借助打包包扎法保证扩张皮瓣成活。 结果 :除 1例因血肿改用全厚皮片移植治疗外 ,所有扩张皮瓣与移植皮片均 10 0 %成活 ,术后功能满意 ,外形良好 ,达到了预期的美学要求。 结论 :以美学理论为指导 。

Objective:To probe the operative technique and related aesthetic problem of using expanded skin flap to repair cicatricial contracture of neck. Methods:The amount,capacity and implanted site of expander were selected by means of the site,range and perifocal condition of cervical cicatrix.The expander support was employed to avoid its translocation during expanding.The modified soft tissue flap in the submandibular region was used to reconstruct the mental region and the mandibular margin and deepen the jaw neck angle.The tie over dressing was employed to ensure the expanded skin flap survival. Results:The survival rates of all expanded skin flaps and transplanted skin grafts except one patient were 100%.The post operative appearance was very good and reached the expected aesthetic results,and the function was satisfactory. Conclusion:The related aesthetic theory and suitable operative technique might be helpful to reach ideal result of function and appearance of neck after plastic operation.