应用扩张后胸三角皮瓣修复24例面颈部瘢痕挛缩畸形的效果分析

Analysis of the effect of expanded deltopectoral skin flaps in repairing scar contracture deformity of faciocervical for 24 cases

目的探讨应用扩张后胸三角皮瓣修复面颈部瘢痕挛缩畸形的效果。方法选择面颈部瘢痕挛缩畸形患者24例,均采用扩张器行常规胸三角皮瓣扩张,8～10周后切除面颈部瘢痕后转移胸三角皮瓣,3～4周后断蒂,完成剩余创面修复。结果全部患者无渗出等情况,出现扩张器外露、局部血肿和局部感染分别为1、3、4例,经对症处理后不影响手术效果,术后效果良好;共行胸三角皮瓣27个,血供不良、皮瓣低温度和坏死分别为4、2、1个,经相应处理后皮瓣愈合良好。随访6个月,全部皮瓣存活良好,未出现睑外翻或颏颈粘连等情况,其色泽及质地等与周围正常皮肤相近,外形美观满意度高。结论应用扩张后胸三角皮瓣修复面颈部瘢痕挛缩畸形能取得良好的效果,是一种较为理想的修复方法,值得临床推广应用。

Objective To discuss the effect of expanded deltopectoral skin flaps in repairing scar contracture deformity of facio-cervical .Methods Twenty-four patients with scar contracture deformity of faciocervical were included into the study .We expanded the deltopectoral skin flap with dilator .8-10 weeks later ,the deltopectoral skin flap were transferred after resection of faciocervical scar .3-4 weeks later ,the pedicles were cut off ,and then the remaining wound were repaired .Results They had not exudation .Ex-pander exposure ,local hematoma and local infection respectively were 1 ,3 ,4 cases ,all did not affect operation effect by symptomatic treatment ,and obtain good postoperative effect .Deltopectoral flap was for 27 cases ,blood supply obstruction low temperature and skin flap necrosis respectively were 4 ,2 ,1 cases ,all get good healing after corresponding .Followed up for 0 .5 year ,all flaps were survived well ,no ectropion or mental cervical adhesion ,its color and texture were similar with surrounding normal skin appearance , so they were got high satisfaction .Conclusion Application of expanded deltopectoral skin flaps to repair scar contracture deformity of faciocervical can achieve good effect and may be an ideal method to repair ,which is worthy of clinical application .