扩张超薄穿支皮瓣修复面颈部广泛性瘢痕

Clinical analysis of expanded ultra-thin perforator flaps for repairing extensive scars on face and neck

目的探讨面颈部广泛性瘢痕患者采用扩张超薄穿支皮瓣修复的效果。方法回顾性分析我院2018年1月-2019年1月收治的面颈部广泛性瘢痕患者90例临床资料,将采用扩张超薄穿支皮瓣修复治疗的47例患者临床资料归为观察组,将采用常规扩张皮瓣修复手术治疗的43例患者的临床资料归为对照组,术后均随访1年。比较两组皮瓣坏死、皮瓣回缩、并发症及生活质量。结果术后随访1年,观察组皮瓣坏死率2.13%(1/47)及皮瓣回缩率4.26(2/47)均低于对照组[18.60%(8/43)、23.26%(10/43)],差异有统计学意义(P<0.05);观察组并发症发生率2.13%(1/47)略低于对照组9.30%(4/43),但差异无统计学意义(P>0.05);两组术后简易生活质量量表(SF-36)中各项评分均比术前高,且观察组比对照组高,差异有统计学意义(P<0.05)。结论面颈部广泛性瘢痕患者采用扩张超薄穿支皮瓣修复的效果较好,可降低皮瓣坏死及回缩率,具有一定的安全性,有效提升患者生活质量。

Objective To explore the clinical effect of expanded ultra-thin perforator flaps for repairing extensive scars on face and neck.Methods The clinical data of 90 patients with extensive facial and neck scars who were treated in our hospital was retrospectively analyzed from January 2018 to January 2019,the clinical data of 47 patients treated with expanded ultra-thin perforator flaps were classified as the observation group.the clinical data of 43 patients treated with conventional expanded flap repair surgery were classified as the control group,they all were followed up for 1 year after operation.The flap necrosis,flap retraction,complications and quality of life were compared between the two groups.Results After 1 year of follow-up,the flap necrosis rate 2.13%(1/47)and flap retraction rate 4.26(2/47)of the observation group were lower,compared with those of the control group[18.60%(8/43),23.26%(10/43)],there was statistically significant difference(P<0.05);the incidence of complications in the observation group was 2.13%(1/47),which was slightly lower compared with 9.30%(4/43)in the control group,but there was not statistically significant difference(P>0.05);the scores of SF-36 in the two groups were higher compared with those before operation,and the observation group was higher compared with the control group,there was statistically significant difference(P<0.05).Conclusion Patients with extensive facial and neck scars have better effects to repair with expanded ultra-thin perforator flaps,which can reduce flap necrosis and retraction rate,has certain degree of safety,and can effectively improve patient’s quality of life.