扩张皮瓣联合放射治疗在躯干部大型及超大型瘢痕疙瘩治疗中的应用效果

Effect of extended skin flap combined with radiotherapy in the treatment of large and super large keloid of trunk

目的探讨扩张皮瓣联合放射治疗在躯干部大型及超大型瘢痕疙瘩切除术后创面修复的应用效果。方法2015年1月至2019年1月,35例大型及超大型瘢痕疙瘩患者接受一期埋植扩张器,注水充足后,二期手术切除瘢痕疙瘩组织,并用扩张皮瓣覆盖创面,术后24h内予浅放射治疗,采用患者与观察者瘢痕评估量表(POSAS)评估治疗效果。结果术后随访12-72个月,随访12个月以上的患者中,31例治愈,3例显效,仅1例部分复发,临床有效率达到97.1%。术前和术后12月的总POSAS评分分别为(59.06±18.03)分和(8.89±4.36)分(P<0.001)。结论扩张皮瓣联合早期放射治疗是治疗躯干部大型及超大型瘢痕疙瘩的有效方法,值得临床推广。

Objective To explore the clinical efficacy of extended skin flap combined with radiotherapy in the treatment of large and super large keloid of trunk.Methods From January 2015 to January 2019,35 patients were implanted with tissue expanders in primary surgery.After adequate water injection,the keloid was resection and expanded flap transfer surgery were carried out.And postoperative superficial electron beam irradiation was implemented.The patient and observer scar assessment scales(POSAS)were used to evaluate changes in keloids pre-and post-operation Results Postoperative follow-up was ranged from 12 to 72 months.After 12 months of follow-up,31 cases were cured,3 cases had obvious effect,and only 1 case had recurrence.The clinical effective rate was 97.1%,and the total POSAS scores before and 12 months after surgery were 59.06±18.03 and 8.89±4.36.Conclusion The extended flap can effectively repair the wound after large and super large keloid resection of the trunk,combined with early superficial electron beam irradiation,tension-reducing suture device and other comprehensive treatment can achieve satisfactory clinical results.