节段设计原则在面部瘢痕外科治疗中的临床应用

Clinical Application of Segmental Excision Technique in Facial Scar Plasty

目的探讨节段设计原则在面部瘢痕治疗中的应用。方法自2012年1月至2014年6月,对38例面部瘢痕患者,在修复面部瘢痕时,以面部张力线、组织器官活动分区,以及面部凹凸曲面为界,将瘢痕分解成多个节段瘢痕,对多节段瘢痕采用手术切除,常规美容外科技术分层减张缝合。于术后3～6个月手术切口愈合稳定后,将留存的节段间点状瘢痕行手术或点阵激光治疗。结果术后随访1～3年,瘢痕质地、色泽较好,无明显瘢痕挛缩,无明显凹陷畸形。结论针对面部线型瘢痕,根据面部皮肤张力线对其进行多节段分解,采用手术联合激光等综合手段,可以获得较好的美容效果。

Objective To observe the effect of segmental excision technique in the treatment of facial scar. Methods From January 2012 to June 2014, 38 cases with facial scar were treated. Based on the skin tension lines, facial organ zonation and contour lines, the whole scar was segmented into two or more segments. Then segmental scars were excised and repaired by plastic technique. After 3-6 months, the punctuate scars were treated with fractional laser skin regeneration technique or directly excision. Results All cases were followed up for 1 to 3 years. The color and texture of scar were improved, moreover, no apparent contracture, incision lines were obscured. Facial contours were restored without distorting surrounding structures. Conclusion Segmental excision technique combining secondary fractional laser skin regeneration technique for the punctuate scars is an effective method for facial scar treatment, especially irregular linear scar and contracture scar.