扩张超薄穿支皮瓣在修复面颈部大面积瘢痕畸形及皮肤缺损中的价值

The Value of Super-thin Perforator Flaps in the Reconstruction of the Extensive Defects and Deformities in the Face and Neck

目的:探讨扩张超薄穿支皮瓣在修复面颈部大面积瘢痕畸形及皮肤缺损中的价值。方法:选取2011年09月至2016年1月我院61例面颈部广泛性瘢痕患者的临床资料,其中以扩张超薄穿支皮瓣修复的患者为实验组,共32例,以常规扩张皮瓣修复的患者为对照组,共29例。分析两组患者皮瓣愈合及皮肤修复情况。结果:对照组患者共出现6例皮瓣远端坏死,坏死率为20.69%,实验组的皮瓣坏死率低于对照组。对照组患者共10例出现皮瓣回缩,术后回缩率为34.48%,而实验组共3例出现皮瓣回缩,术后回缩率为9.38%,实验组患者术后回缩率低于对照组,差异具有统计学意义(P<0.05)术后随访2年,实验组患者的皮瓣厚度均薄于对照组,均未行皮瓣修薄手术,且其外观及肌肉拉伸功能均优于对照组。结论:应用扩张超薄穿支皮瓣修复面颈部大面积瘢痕畸形及皮肤缺损是一种安全有效的手术方法,能够降低皮瓣坏死率,且能最大程度恢复面部外观及功能。

Objective： To observe the value of super-thin perforator flaps in the reconstruction of the extensive defects and deformities in the face and neck. Methods： From January 2003 to January 2016,61 cases with extensive facial and cervical scars were collected in our hospital. The patients in control group were treated by conventional pre-expanded flaps,total 32 cases. The patients in experimental group were treated by super-thin perforator flaps. The skin flap healing and skin repair was analyzed. Results： The control group has6 cases of flap necrosis and the flap necrosis rate were 20.69%.And the experimental group has 1 cases of flap necrosis and the flap necrosis rate were 3.13%,which was significantly lower than the control group（ P〈0.05）.The control group has 10 cases of flap retraction and the flap retraction rate were 34.48%,and the experimental group has 3 cases of flap retraction and the flap retraction rate were 9.38%,there difference was significant（ P〈0.05）.All patients were followed up for 2 years showed that the super-thin perforator flaps thinner than the conventional pre-expanded flap,thus avoiding secondary flap debulking and revisions. And the appearance and muscle stretch function of experimental group were better than the control group. Conclusion： The superthin perforator flaps is a safe and effective surgical method to repair the extensive defects and deformities in the face and neck. It can reduce the flap necrosis rate,restore facial appearance and function.