额颞部扩张皮瓣在修复面颈部瘢痕中的应用效果观察

The effect of frontotemporal expansion flap in the repair of facial and neck scar

目的研究额颞部扩张皮瓣修复面颈部瘢痕的效果。方法选取我院面颈部瘢痕患者104例(2018年10月~2019年10月),均行额颞部扩张皮瓣。统计手术结果(手术时间、术中出血量、愈合时间、愈合分度、皮瓣坏死情况、形态及功能),并进行典型案例分析。结果扩张时间(45.82±6.78)d;手术时间(78.92±7.56)d;术中出血量(36.58±10.41)ml;愈合分度:Ⅰ度69例,Ⅱ度35例;皮瓣坏死情况:术后1例患者皮瓣出现暗紫色及明显肿胀,静脉回流出现障碍,给予针刺、按压、放血等处理,皮瓣完全恢复正常;形态与功能:转移皮瓣后血运、色泽正常,外形正常,面部有线状瘢痕,未发现功能障碍,较平整,未发现增生性瘢痕;皮瓣质地、厚度、色泽与面部皮肤相似度较高,颈部旋转、左右侧屈、后伸、前屈等功能均明显改善,颌颈角为90°左右,修复效果满意。结论额颞部扩张皮瓣修复面颈部瘢痕效果显著,血运可靠,皮瓣坏死情况少,能较好恢复瘢痕区形态及功能。

Objective To study the effect of frontotemporal expanded flap in the repair of facial and neck scar.Methods A total of 104 patients with facial and neck scar (October 2018-October 2019) were selected to receive frontotemporal expanded flap.The operation results (operation time,intraoperative hemorrhage,healing time,healing index,flap necrosis,morphology and function) were statistically analyzed,and typical cases were analyzed.Results Expansion time (45.82±6.78) d;operation time (78.92±7.56) d;intraoperative bleeding volume (36.58±10.41) ml;healing index:69 cases of grade I,35 cases of grade II;skin flap necrosis:1 case of skin flap appeared dark purple and obvious swelling after operation,venous reflux appeared obstacles,and the skin flap was completely restored to normal after acupuncture,compression,bleeding and other treatment;shape and function:transfer skin flap The skin flap has a high similarity in texture,thickness and color with the facial skin.The functions of neck rotation,left and right lateral flexion,back extension and forward flexion are significantly improved.The angle of jaw neck is about 90 ° and the repair effect is satisfactory.Conclusion The expanded frontotemporal flap is effective in repairing facial and neck scar,with reliable blood supply and less necrosis of the flap,which can better restore the shape and function of the scar area.