髂腹股沟皮瓣修复会阴前区增生性瘢痕和瘢痕疙瘩的疗效

Effect of ilioinguinal flap in the repair of hypertrophic scars and keloids in the anterior region of perineum

目的探讨髂腹股沟皮瓣修复会阴部增生性瘢痕和瘢痕疙瘩的疗效。方法回顾性分析21例会阴前区(阴阜和耻骨联合周围)增生性瘢痕和瘢痕疙瘩患者的临床资料,患者均行髂腹股沟带蒂皮瓣修复。术后观察皮瓣存活情况,随访期间观察患者供受区瘢痕情况及皮瓣颜色、质地。末次随访时采用视觉模拟评分法(VAS)评价患者满意度。结果术后患者皮瓣均全部成活,供区均一期闭合,切口均一期愈合。随访期间供受区切口均愈合良好,瘢痕隐蔽,皮瓣颜色红润、质地良好,未出现破溃、继发性瘢痕挛缩畸形等。末次随访时,VAS评分7~10分,平均(8.6±1.3)分,患者或患者家属满意度较高。结论髂腹股沟皮瓣修复会阴前区增生性瘢痕和瘢痕疙瘩具有血供可靠,易切取,与受区组织质地、厚度、颜色相近等特点,可获得满意疗效。

Objective To explore the effect of ilioinguinal flaps in the repair of perineal hypertrophic scars and keloids.Methods The clinical data of 21 patients with hypertrophic scars and keloids in the anterior perineal region(around the mons pubis and pubic symphysis)were analyzed retrospectively.All patients underwent ilioinguinal pedicle flap repair.The survival of the flaps was observed after the operation,and the scars,color and texture of the flaps in the donor and recipient sites were observed during the follow-up.At the last follow-up,visual analogue scale(VAS)was used to evaluate patients’satisfaction.Results After operation,all flaps survived,the donor sites were closed primarily and the incisions healed primarily.During the follow-up,incisions in the donor and recipient sites healed well,the scar was hidden,flaps were ruddy in color and good in texture,and there was no ulceration or secondary scar contracture deformity.At the last follow-up,the VAS score was 7 to 10 points,with an average of(8.6±1.3)points,and patients’satisfaction was high.Conclusion The ilioinguinal flap repairing hypertrophic scars and keloids in the anterior region of perineum has the characteristics of reliable blood supply,easy cutting,and similar texture,thickness,and color to the recipient area,which can obtain satisfactory efficacy.