多只扩张器超量扩张修复大面积瘢痕性秃发

Excessive expansion of scalp with multiple dilators to repair cicatricial alopecia in a large area

目的 探讨应用多只扩张器超量扩张头皮修复大面积瘢痕性秃发的临床效果.方法 Ⅰ期手术：根据秃发区的形状、面积大小,选择多只扩张器,在肿胀麻醉下,置于头部有发区帽状腱膜下,注射壶外置.超量扩张3～6个月,以获得额外有发头皮.Ⅱ期手术：将扩张器取出,切除瘢痕,将扩张后的有发头皮,采用滑行推进皮瓣、旋转皮瓣与易位皮瓣联合运用的手术方式,修复头皮秃发区.结果 23例患者术后秃发区修复效果良好,外观满意.结论 多只扩张器超量扩张可获得大量额外扩张头皮.合理设计皮瓣转移术,最大限度地提高了扩张皮肤的利用率,可修复大面积瘢痕性秃发,修复效果良好.

Objective To investigate the application of multiple dilators for excessive expansion of scalp with hair covering and integrated use of expanded flap to repair cicatricial alopecia in a large area.Methods stage Ⅰ surgery was performed as follows：multiple dilators were chosed and embedded below the galea aponeurotica of the scalp with hair covering according to the bald hair shape,size of the alopecia area.Excessive expansion was conducted for 3 to 6 months to get the extra hair scalp.Stage Ⅱ surgery was as follows：Dilators were removed and scar areas were resected,followed by combined use of sliding advancement flap,rotation flap and translocation flap to repair scalp alopecia.Resluts The postoperative effect of all patients was ideal with satisfied appearance.Conclusions Multiple dilator excessive expansion may obtain a large number of additional expansion scalp,combined by reasonable use of skin flap transfer technology,which can be used to repair the large scarring alopecia and get a good clinical effect.