头皮扩张皮瓣移植联合光子脱毛修复额部大面积瘢痕

Scalp expanded flap combined with IPL hair removal for large area scar on forehead

目的探讨头皮扩张皮瓣移植联合光子脱毛技术修复额部大面积瘢痕的临床效果。方法2010年7月至2012年11月，对9例额部大面积瘢痕患者，应用邻位头皮扩张皮瓣移植联合光子脱毛技术治疗。手术共分三期进行：①根据额部瘢痕的大小和形状在邻位头部放置皮肤扩张器，术后定期注水扩张；②待扩张头皮皮肤量达到要求后，取出扩张器，行头皮扩张皮瓣转移修复额部瘢痕切除创面；③二期术后10d，设计发际线，对发际线以外的额部转移皮瓣进行光子脱毛治疗，一般经3—5次治疗后，皮瓣即基本脱毛干净。结果9例9个皮瓣完全覆盖额部皮肤缺损，最远达上睑区，血供良好，全部存活；光子脱毛效果确切，经术后5～11个月随访，脱毛后皮瓣与面部皮肤组织在色泽、质地、厚度等方面匹配良好，皮瓣毛发密度每平方厘米减少90％以上，重建发际线自然，效果满意。结论头皮扩张皮瓣移植联合光子脱毛技术是修复额部大面积瘢痕的较好方法。

Objective To investigate the therapeutic effect of scalp expanded flap combined with IPL hair removal for large area scar on forehead. Methods From Jul. 2010 to Nov. 2012, 9 cases with large area scar on forehead received treatment of adjacent scalp expanded flap combined with IPL hair removal. One the first stage, the expander was implanted under the scalp near the forehead scar, followed by expansion process. When the expansion was completed, the expanded flap was transferred to cover the wound after scar excision. 10 days after flap transposition, the forehead hair line was designed and extra hair on flap underwent IPL hair removal. After 3 - 5 treatments, the hair on flap was almost removed. Results All the scalp flaps survived completely. IPL hair removal had exact effect. The patients were followed up for 5 - 11 months. The hair density on the flap decreased by more than 90%. The flap had a good match with surrounding facial skin in color, texture and thickness. The reconstructed forehead hair line was satisfactory. Conclusions It is a good option to reconstruct large area scar on forehead with scalp expanded flap combined with IPL hair removal.