小切口扩张器埋植联合浅层放疗治疗64例胸部大面积瘢痕疙瘩的护理

Post-surgery care for 64 cases with large area keloid on the chest after small incision expander implantation plus superficial radiotherapy

目的:总结采用小切口皮肤软组织扩张器埋植联合浅层放疗治疗胸部大面积瘢痕疙瘩的护理经验。方法:回顾性分析64例胸部大面积瘢痕疙瘩患者采用扩张器进行治疗期间的护理经验。结果:64例患者共70个扩张器均顺利完成治疗,主要并发症为扩张皮瓣血液循环不良6例、扩张器注水壶机械性回缩4例、扩张器外露2个及扩张皮瓣表面张力性水疱1例。随访6~48个月,7例复发,余57例患者主诉瘙痒、疼痛等症状明显改善,效果满意。结论:根据手术的不同阶段做好相应的护理,如心理护理、手术区皮肤准备、扩张皮肤的观察处理及二期手术后移植皮瓣的观察等,对于保证手术的成功非常重要。

Objective： To summarize the experience on post-surgery care for large area keloid of the chest treated with skin incision expander implantation plus superficial radiotherapy. Methods： They retrospectively reviewed the post-surgery care for 64 patients whose large keloids on the chest were underwent skin incision expander implantation plus superficial radiotherapy. Results： Seventy expanders were successfully completed in 64 patients. The main complications included poor blood circulation in the expanded skin flap（6 cases）, mechanical retraction of injection pot（4 cases）, expander exposure（2 cases） and tension blister on the flap surface（1 case）. Conclusions： To ensure a successful surgery, it is crucial to give proper post-surgery care at different stages, such as psychological care, skin preparation on the surgical site, observation and care of the expanded skin, and observation of the transplanted flaps.