游离股前外侧穿支皮瓣修复烧伤瘢痕癌术后皮肤软组织缺损的临床效果研究

Clinical Effect of anterolateral thigh perforator free flap surgery to repair burn scar carcinoma of the skin and soft tissue defects

目的研究并探讨游离股前外侧穿支皮瓣修复烧伤瘢痕癌术后皮肤软组织缺损的临床效果。方法选取2011年6月-2016年1月深圳市龙岗中心医院收治的18例烧伤瘢痕癌术后皮肤软组织缺损患者,游离股前外侧穿支皮瓣对患者缺损的皮肤进行修复,观察患者的手术时间、术中出血量、术后并发症发生情况,并对比患者治疗前后的创面肉芽形态评分、疼痛评分、瘙痒评分、皮肤感觉恢复情况。结果 18例患者手术后皮瓣均有效成活,手术平均时间为（215.63±37.59）min,术中出血量为150-290ml,平均出血量为（219.83±36.54）ml。与治疗前相比,治疗后患者的创面肉芽形态评分、疼痛评分、瘙痒评分均明显改善（P〈0.05）。与治疗前相比,治疗后患者的皮肤感觉恢复情况明显更佳（P〈0.05）,S4分级的病例数明显增多（P〈0.05）。结论在烧伤瘢痕术后皮肤软组织缺损患者的临床治疗中,采取游离股前外侧穿支皮瓣进行修复,具有显著的治疗效果,可有效改善患者的皮肤缺损情况,缓解创面疼痛、瘙痒。

Objective To study and explore the anterolateral thigh perforator free flap after repair soft tissue defects of the clinical effects of burn scar carcinoma. Methods June 2011-January 2016, Longgang Central Hospital treated 18 cases of burn scar defects in patients with cancer after skin and soft tissue, anterolateral thigh perforator free flap of skin repair in patients with defects observed in patients operative time, blood loss, postoperative complications, and to shape before and after comparison of granulation patients score, pain score, score itching, skin feel recovery. Results 18 patients were effective surgical flaps survived, mean operation time was（215.63 ± 37.59） min, blood loss was 150 - 290 ml, the average blood loss was（219.83 ± 36.54） ml. Compared with before treatment, after treatment, the patient＇s morphology granulation score, pain score, pruritus scores were significantly improved（P 0.05）. Compared with before treatment, after treatment, the patient＇s skin feel significantly better recovery（P 0.05）, S4, the number of cases increased significantly grading（P 0.05）. Conclusion The clinical treatment of burn scars after skin and soft tissue defects in patients taking anterolateral thigh perforator free flap repair, with significant therapeutic effect, can effectively improve the patient＇s skin defect, wound relieve pain, itching.