维持扩张期对扩张皮肤张力和即时回缩率影响的研究

The influence of expansion maintenance period upon in vivo skin tension and immediate stretch-back rate of the expanded skin

目的 研究维持扩张期对扩张皮肤在体张力和即时回缩率的影响 ,并以此指导临床。方法 以狗为动物模型 ,在 6只成年大狗的背侧 ,对称设计 6个区域。实验分为注水 2周组、6周组、实验对照组和空白对照组。分析比较各组的在体张力和即时回缩率 (包括有包膜和去包膜 )。结果皮肤在体张力和即时回缩率随着维持期的延长逐渐减小 ,而注水期的长短对其影响不大 ;去除包膜后皮肤的在体张力和即时回缩率明显降低。在此基础上 ,临床应用 16例 2 3个扩张器的效果较好。结论 在皮肤软组织扩张术中 ,可以通过缩短注水期 (2周左右 )、适当延长维持期 (4周 )以及去包膜的方法 ,可以达到减少扩张皮肤的在体张力和即时回缩率 ,增加扩张皮肤面积的目的。

Objective\ The study was to investigate the influence of maintenance period of expansion upon skin tension and immediate stretch back rate of the expanded skin. Methods\ 30 expanders (240 ml) were implanted in six adult dogs, which were divided into four groups: group A with 2 week saline injection of the expander; group B with 6 week injection; group C with sham operation and group D as the blank control group. The first two groups were subdivided into three groups respectively according to different maintaining times of one week, two weeks and four weeks. When full inflation was finished, a 4 cm×7 cm expanded flap was created and in vivo skin tension and stretch back ratio of the flap were measured. The Comparison was made in terms of in vivo skin tension and immediate stretch back ratio between different injection and different maintenance periods. Results\ With expansion maintenance time increasing, the in vivo skin tension and immediate stretch back ratio decreased. After the capsule of the expand skin flap was removed, the in vivo skin tension and immediate stretch back rate significantly reduced. Based on the experimental results, 16 patients were treated with implantation of 23 expanders. Their average expander injection time was 14 days and the average maintenance time was 25 days. All expanders obtained good results except one extrusion. Conclusion\ In skin and soft tissue expansion, in vivo skin tension and immediate stretch back ratio can be reduced through prolonged maintenance of expansion and capsule removal from the expanded skin flap. \;