软组织扩张术在巨大瘢痕性秃发美学修复中的应用

Application of Soft Tissue Expansion Technique in the Aesthetic Reconstruction of Giant Cicatricial Alopecia

目的探讨与分析软组织扩张技术在巨大瘢痕性秃发修复中的美学要点。方法回顾性分析2011年1月-2013年1月采用头皮下软组织扩张术修复的12例巨大瘢痕性秃发患者的临床资料,其中瘢痕性秃发区面积50-180 cm^2。结果本组患者12例,共置入扩张器39只,均未出现扩张器外露、伤口感染、扩张皮瓣局部坏死等并发症。2例患者一次扩张后,扩张皮瓣不能完全覆盖创面,于术后1月行二次扩张后完全覆盖创面;其余10例均一次扩张修复创面;所有患者均Ⅰ期愈合。皮瓣缝合部位可见细小瘢痕,毛发生长均匀,经6月-3年随访,形态外观较为满意。结论大面积头皮秃发畸形需要使用软组织扩张术进行修复。完善的术前设计可以达到更好的美学修复效果。

Objective To discuss the key points of soft tissue expansion technique in the aesthetic reconstruction of giant cicatricial alopecia. Methods A total of 12 giant cicatricial alopecia cases reconstructed with soft tissue expansion technique admitted from January 2011 to January 2013 were analyzed retrospectively. The area of cicatricial alopecia ranged from 50 to 180 cm^2. Results 39 expanders were placed in all12 cases without complications such as expander exposion,wound infection and local necrosis of expansion flap.2 cases were reconstructed completely with twice expansion surgery,the others were repaired by once expansion surgery. All 12 cases were cured in stage I. After 6 months to 3 years follow-up,normal scalp appearance were achieved in all cases with little scar around the incision and well-distributed hair growth. Conclusions Large bald deformity could be reconstructed with soft tissue expansion technique. Optimal aesthetic results would be achieved with efficient preoperative preparation.