扩张后皮瓣修复四肢瘢痕挛缩的临床效果

Repair of extremity scar contracture by expanded local flaps

探讨扩张后皮瓣修复四肢烧伤后瘢痕挛缩的临床效果。方法2000年1月至2013年12月,空军军医大学西京医院整形外科共收治采用扩张后皮瓣修复四肢瘢痕挛缩患者30例,其中男11例,女19例,年龄11~34岁。手术过程包括扩张器置入、瘢痕切除及扩张皮瓣转移。术后常规抗瘢痕治疗。结果30例均完成扩张器置入术将瘢痕切除,直接推进皮瓣或易位皮瓣修复瘢痕切除后创面。治疗时间2~4个月,平均3个月。其中3例扩张囊自切口处外露;3例扩张皮肤局部红肿,但均未影响手术;皮瓣转移后成活良好,无局部坏死等并发症。随访6~12个月25例,切口均有轻度瘢痕,效果满意。结论扩张后皮瓣是修复四肢纵向、斜行挛缩瘢痕的较好方法。

Objective To investigate the application of expanded local flap in repairing extremity scars.Methods Thirty patients with extremity scars contracture as a result of trauma,surgery or infection during July 2000 and March 2013 were included.There were 11 male and 19 female patients with age ranging from 11 to 34 years.Tissue expansion,scar resection,flap transfer and scar management were involved in this process.Results There 24 patients suffered from upper extremity scars and 6 patients suffered from lower extremity scars.Expander exposure was noted in 3 patients,and 3 patients suffered from infection during the expansion.During the 6-month to 1-year follow-up,all patients satisfied with the results in terms of the skin texture,color,flexibility after the treatment with expanded local skin flap.Conclusions The expanded local flaps are suitable for the repair of the longitudinal and oblique scars in the extremities.