头面部非黑色素瘤皮肤癌一期切除术后局部皮瓣的修复治疗

Repair and treatment with local skin flap after primary surgical resection of non melanoma skin cancer

目的探讨头面部非黑色素瘤皮肤癌一期切除术后采用局部皮瓣修复的临床疗效。方法选择2008年9月至2015年9月在我院就诊并行手术治疗的176例头面部皮肤癌患者,根据患者切除术后的修复方案分为3组,分别为拉拢缝合组41例、局部皮瓣修复组81例及皮片移植组54例,对比3组患者的术后修复效果。结果拉拢缝合组愈合良好率为68.39%(28/41),局部皮瓣修复组愈合良好率为98.77%(80/81),皮片移植组愈合良好率为83.33%(45/54),局部皮瓣修复组的愈合良好率明显高于其他2组,差异有统计学意义(P<0.05)。在满意度方面,局部皮瓣修复组的满意度明显优于拉拢缝合组,差异具有统计学意义(P<0.05),但与皮片移植组的满意度相比,差异无统计学意义(P>0.05)。对3组患者进行为期1年的随访,均未出现复发及远处转移的情况。结论对头面部非黑色素瘤皮肤癌的患者,在一期切除术后可以采用局部皮瓣修复治疗方案,不仅愈合良好率高,同时患者满意度也有显著提升,术后复发率及远处转移率低。

Objective To investigate the clinical effect of treatment with local skin flap after primary surgical resection of non melanoma skin cancer. Methods A total of 176 patients with head and facial skin cancer who were admitted into our hospital from September 2008 to September 2015 were divided into three groups according to different repair plans. Namely, the suture group （41 cases） , the local skin flap group （81 cases） and the skin graft group （54 cases）. The repair effect of the three groups were compared after the operation. Results The good rate was 68.39% （28/41） in the suture group,98.77% （80/81） in the local skin flap group,and 83.33% （45/54） in the skin graft group, and it was significantly higher than any of the other two groups with statistically significant difference （ P 〈 0.05 ）. The satisfaction rate of the local skin flap group was significantly better than that of the suture group, and the difference was statistically significant（ P 〈 0.05 ）. But there was no significant difference in the satisfaction rate when compared with the skin graft group（ P 〉 0.05 ）. The 3 groups were followed up for a period of 1 year, as a result, there was no recurrence and distant metastasis. Conclusion For patients with head and facial non melano- ma skin cancer,repaired with local skin flap healing treatment after primary surgical resection can not only get high healing rate hut also sig- nificant improvement of patient satisfaction rate. In addition.it can lower the rate of recurrence and distant metastasis after ~eration.