皮肤软组织扩张术联合整形外科缝合技术治疗头皮缺损

Treatment of Scalp Defect by Skin Soft Tissue Expansion Combined with Plastic Surgery Suture Techniques

目的：探讨皮肤软组织扩张术联合整形外科缝合技术治疗头皮缺损的临床疗效。方法：选取本院2013年6月-2015年12月7例头皮缺损患者,采用皮肤软组织扩张术联合整形外科缝合技术治疗。手术共分两期进行：一期将皮肤扩张器置入邻位头皮下,定期注水扩张;二期取出扩张器,行头皮扩张皮瓣转移覆盖头皮病变切除后的缺损创面,采用整形外科缝合技术进行修复。结果：本组7例头皮缺损采用皮肤软组织扩张术联合整形外科缝合技术治疗,皮瓣全部成活,随访4~12个月,平均7个月,根据张浩等对皮瓣修复术后疗效的评估方法进行评定：本组病例评分均在8~10分,皮瓣外形、色泽、质地满意;根据贾明等对头部修复区毛发生长情况满意度评分方法进行评定：本组病例评分均在5~10分,修复区毛发生长自然,与周围毛发衔接良好,美学效果满意,无毛囊炎等并发症的发生。结论：皮肤软组织扩张术联合整形外科缝合技术是治疗头皮缺损的理想方法。

Objective： To investigate the clinical effect of skin soft tissue expansion combined with plastic surgery suture techniques in treating scalp defect.Method： From June 2013 to December 2015, 7 cases of patients with scalp defect in our hospital were selected,, the skin soft tissue expansion together with plastic surgery suture techniques was applied to treating. The operation was performed by two phases.Phase 1 involved placement of skin expander to the adjacent scalp and regular water injection into the expander for skin expansion.In phase 2, the skin expander was taken out, the expanded flap was transferred to cover the dermal wound generated after removal of scalp lesion, and the wound was repaired by plastic surgery suture techniques.Result： All 7 cases of patients with scalp defect were treated with skin soft tissue dilation and plastic surgery suture techniques.After treatment, all their flaps survived.Follow-up visits lasted 4 to 12 months, with 7 months as the average.Results from the evaluation according to Zhang Hao and other scholar＇s methods of evaluating the postoperative effect of skin flap repair were as follows.The cases in this group were all graded at between 8 and 10, and showed satisfactory flap shape, color and texture.Results from the evaluation according to Jia Ming and other researcher＇s methods of scoring hair growth status in the head repair area were as follows.The cases in this group were all scored at between 5 and 10, showed natural hair growth in the repair area, good hair cohesion with surrounding hair, and satisfactory aesthetic effect without complications such as epifolliculitis.Conclusion： Skin soft tissue expansion combined With ＇plastic surgery suture techniques is the ideal way of treating scalp defect.