面颈部皮肤撕脱伤整形修复效果探讨

Treatment of Skin Avulsion on the Face and Neck Using Principle of Plastic Surgery

目的:探讨采用整形原则修复面颈部皮肤撕脱伤,提高撕脱组织存活率、减少术后瘢痕的效果。方法;2017年6月-2017年9月笔者医院收治面颈部皮肤撕脱伤患者17例,共19处损伤。在急诊根据撕脱皮瓣损伤程度进行相应处理:撕脱皮瓣面积相对较小、组织无明显碾挫伤者,清创后行撕脱皮瓣原位缝合;撕脱皮瓣末端血供障碍者,将其远端修成真皮下血管网皮瓣或全厚皮片原位回植,予以打包包扎,并应用美容缝合技术。结果:18处皮瓣术后成活良好,仅1处皮瓣发生小面积坏死,经换药后愈合,术后瘢痕不明显,外形满意,功能恢复良好。结论:对于面颈部皮肤撕脱伤,急诊外伤处理过程中恰当地运用整形美容外科原则及技术,可使局部创伤在最大限度上获得功能及美学修复,值得临床推广。

Objective To explore the effect of using principle of plastic surgery to repair the face and neck avulsion skin in order to increase the survival rate of avulsed tissue and reduce scar. Methods 17 cases of avulsion injury of the face and neck were treated in our hospital from June 2017 to September 2017, there were 19 injuries. According to the degree of injury, we adopted different treatment strategies： If the flap was small and the tissue was not obviously crushed, we sutured the flap in situ. If the blood supply of the avulsion flap is poor, we would trim it into a flap with subdermal vascular network or full-thickness skin, then replant it in situ with moderate pressure dressing and apply the technique of cosmetic suture. Results 19 wounds survived after using appropriate surgical procedure according to the principle of plastic surgery. Postoperatively, only small area of the a avulsion skin occurred necrosis, but after dressing and healing after skin grafting, there was no obvious scar appearance. The patients were satisfied with the good functional recovery and wound reparation. Conclusion Suitable disposal to the face and neck avulsion skin applying the cosmetic surgery technique and principle can obtain maximatily functional and aesthetic recovery. It is worthy for clinical promotion.