皮肤恶性肿瘤的切除与修复

Excision and repair of the skin malignant tumors

目的:探讨皮肤恶性肿瘤的手术治疗与修复的临床效果。方法:本组经病理检查证实的38例皮肤恶性肿瘤,采用不同类型的皮瓣、肌皮瓣、游离植皮和手术后直接缝合等四种不同的手术方法进行修复,其中肌皮瓣治疗13例(腓肠肌皮瓣4例,背阔肌皮瓣6例,阔筋膜张肌皮瓣2例,腹直肌皮瓣1例),呈底内侧皮瓣5例,邻近皮瓣3例,游离大块植皮12例,肿瘤切除后直接缝合5例。结果:手术全部成功,21例获得随访,随访1～8年,19例术后恢复良好,2例术后局部复发,再次手术后治愈。结论:对皮肤恶性肿瘤的切除与修复方法需根据病情而定。应用肌皮瓣和皮瓣有较好的临床效果。

Objective:To study the method to repair skin defect after excision of malignant tumors and its clinical effect.Methods:38 cases of skin malignant tumors proved by pathological examination were excised and repaired.Four different operative techniques were applied for repair,including various skin flap types,musculocutaneous flap,free skin graft and direct suturing,in these musculocutaneous flaps 13 cases(gastronomies flaps 4 latissimus flaps 6,tens of fascia lata musculocutaneous flaps 2 and transverse rectus abdominis musculocutaneous flap 1),plantaris mediolies flaps 5 eases,random flap 3 cases,free skin graft 12 cases and direct.suturing in 5 cases.Results:All the flaps survived with good re- suits,21 cases were followed for 1 to 8 years in whom 19 patients were healed,2 relapsed.The relapsed cases were cured after second operation.Conclusion:The selection of technique of exicion and repair of skin malignant tumor should be based on the objective conditions.The musculocutaneous flap and differ- ent flaps have better clinical effects.