经扩张后随意型皮瓣修复术治疗面颈部烧伤后瘢痕患者的临床疗效

The clinical effect of random pattern flap surgery after tissue expansion in treatment of facial and neck burn scar

目的分析经扩张后随意型皮瓣修复术治疗面颈部烧伤后瘢痕患者的临床疗效。方法抽取我院86例面颈部烧伤后瘢痕患者(2017年5月-2020年2月),依照治疗方案不同分为两组,各43例,对照组接受单纯邻近皮瓣修复术治疗,观察组接受经扩张后随意型皮瓣修复术治疗,比较两组治疗效果。结果(1)临床疗效:术后1个月,观察组临床总有效率较对照组高(P<0.05);(2)瘢痕程度:术后3个月,观察组温哥华瘢痕量表(VSS)评分、患者瘢痕评估量表(PSAS)、观察者瘢痕评估量表(OSAS)均较对照组低(P<0.05);(3)血清细胞因子水平:术后10d,观察组血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)、血小板源生长因子(PDGF)、PDGF受体α较对照组高(P<0.05);(4)并发症:两组并发症发生率对比,无明显差异(P>0.05)。结论经扩张后随意型皮瓣修复术治疗面颈部烧伤后瘢痕可取得显著效果,能有效调节细胞因子表达,促进瘢痕恢复,且安全性高。

Objective To analyze the clinical effect of random pattern flap surgery after tissue expansion in the treatment of scar patients after facial and neck burn.Methods A total of 86 patients with facial and neck scars after burns in our hospital(from May 2017 to February 2020)were selected and divided into two groups according to different treatment plans,with 43 cases in each group.The control group received only adjacent pattern flap surgery,and the observation group received random pattern flap surgery after tissue expansion.The therapeutic effects of the two groups were compared.Results(1)Clinical efficacy:1 month after operation,the total clinical effective rate of the observation group was higher than that of the control group(P<0.05).(2)Scar degree:3 months after operation,the Vancouver Scar Scale(VSS)score,Patient Scar Assessment Scale(PSAS),and Observer Scar Assessment Scale(OSAS)of the observation group were lower than those of the control group(P<0.05).(3)Serum cytokine levels:10 days after operation,vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),platelet-derived growth factor(PDGF)and PDGF receptorαin the observation group were higher than those in the control group(P<0.05).(4)Complications:There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Random pattern flap surgery after tissue expansion can achieve significant results in the treatment of facial and neck burn scar.It can effectively regulate the expression of cytokines,promote scar recovery,and is highly safe.