胸廓内动脉穿支为蒂的扩张后胸三角皮瓣游离移植修复面部软组织缺损价值

The value of free transplantation of expanded thoracic triangular flap pedicled with internal thoracic artery perforator to repair facial soft tissue defect

目的分析胸廓内动脉穿支为蒂的扩张后胸三角皮瓣游离移植修复术修复面部软组织损伤的效果。方法选取2015年1月到2017年1月我院收治的行面部软组织修复术的患者62例作为研究对象,以随机为原则分成试验组(扩张后胸三角皮瓣游离移植修复治疗)和对照组(游离皮片移植治疗),每组各31例。比较两组患者术后皮肤挛缩率,通过我院自制问卷量表分析两组患者对修复术的满意程度,统计两组患者术后并发症发生情况。结果术后3、6、12、24个月,试验组患者皮肤挛缩发生率显著低于对照组,差异有统计学意义(P<0.05);试验组患者对于治疗周期的满意度评分低于对照组,而术后皮肤色泽、术后皮肤弹性质地、治疗效果满意度评分显著高于对照组,差异有统计学意义(P<0.05);试验组总满意率为93.55%,显著高于对照组的80.65%,差异有统计学意义(P<0.05);试验组患者不良反应总发生率为6.45%,显著低于对照组的16.13%,差异有统计学意义(P<0.05)。结论扩张后胸三角皮瓣游离移植修复面部软组织缺损能够降低患者皮肤挛缩,改善患者皮肤色泽和弹性质地,提高患者满意度,降低并发症发生率,值得临床推广使用。

Objective To analyze the effect of free transplantation and repair of expanded thoracic triangular flap pedicled with perforating branch of internal thoracic artery in repairing facial soft tissue injury.Methods A total of 62 patients undergoing facial soft tissue repair admitted to our hospital from January 2015 to January 2017 were selected as the research objects,and randomly divided into the experimental group(free transplantation of expanded thoracic triangular flap for repair)and the control group(free skin graft for repair),with 31 patients in each group.The postoperative skin contracture rate of the two groups was compared.The satisfaction degree between the two groups with repair was analyzed through the self-made questionnaire scale in our hospital.The occurrence of postoperative complications between the two groups was counted.Results Three months after operation,the incidence rate of skin contracture was significantly lower in the experimental group than that in the control group,with significant difference between the groups(P<0.05).The satisfaction score of patients was lower in the experimental group for the treatment period than that in the control group,while the satisfaction scores of skin color,elastic texture and treatment effect were significantly higher than those in the control group.The satisfaction rate of patients was 93.55% in the experimental group,which was significantly higher than that of 80.65% in the control group,with significant difference between the groups(P<0.05).The total incidence of adverse reactions was 6.45% in the experimental group,which was significantly lower than that of 16.13% in the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion Free transplantation of expanded thoracic triangular flap to repair facial soft tissue defects can reduce skin contracture,improve skin color and elastic texture,improve patient satisfaction and reduce the incidence of complications of patients,which is worthy of clinical application.