Data are scarce regarding surgical and non-surgical education in accredited Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowships in theUnited States. We compared surgical and non-surgical and educatio...Data are scarce regarding surgical and non-surgical education in accredited Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowships in theUnited States. We compared surgical and non-surgical and education among training programs and expected surgical comfort level with pelvic reconstructive procedures from the perspective of the fellow and program director. An online survey was distributed to program directors and fellows from the 39 accredited FPMRS fellowships at the time (2010). Domains evaluated in the survey were academic education requirements;surgical approaches to prolapse and to incontinence;other surgical procedures;and research and publication expectations. In total, forty fellows from 21 programs and directors from 27 programs. The most common surgical procedures performed for apical, anterior, and posterior prolapse were uterosacral ligament suspension, native tissue anterior colporrhaphy, and posterior colporrhaphy, respectively. Differences in perceived surgical comfort level were seen for coccygeus suspension, graftreinforced posterior colporrhaphy, rectus fascial sling, urethral bulking agent, cystoscopic ureteral stent placement and bowel repair. A greater proportion of program directors reported that fellows would be comfortable performing these procedures upon graduation than the proportion reported by the fellows themselves. Differences exist in FPMRS training nationwide, however, responding fellows appeared to be trained in multiple approaches to prolapse repair. Differences were seen in surgical comfort level as perceived by fellows and program directors.展开更多
Aim： To characterize the feasibility of the surgical replacement of the penile tunica albuginea （TA） and to evaluate the value of a porcine bladder acellular matrix （BAM） graft. Methods： Acellular matrices were ...Aim： To characterize the feasibility of the surgical replacement of the penile tunica albuginea （TA） and to evaluate the value of a porcine bladder acellular matrix （BAM） graft. Methods： Acellular matrices were constructed from pigs＇ bladders by cell lysis, and then examined by scanning electron microscopy （SEM）. Expression levels of the mRNA of the vascular endothelial growth factor （VEGF） receptor, fibroblast growth factor （FGF）-1 receptor, neuregulin, and brain-derived neurotrophic factor （BDNF） in the acellular matrix and submucosa of the pigs＇ bladders were determined through the reverse transcription-polymerase chain reaction （PCR）. A 5 mm× 5 mm square was excised from the penile TA of nine rabbits. The defective TA was then covered in porcine BAM. Equal numbers of animals were sacrificed and histochemically examined at 2, 4 and 6 months after implantation. Results： SEM of the BAM showed collagen fibers with many pores. VEGF receptor, FGF-1 receptor and neuregulin mRNA were expressed in the porcine BAM; BDNF mRNA was not detected. Two months after implantation, the graft sites exhibited excellent healing without contracture, and the fusion between the graft and the neighboring normal TA appeared to be well established. There were no significant histological differences between the implanted tunica and the normal control tunica at 6 months after implantation. Conclusion： The porcine BAM graft resulted in a structure which was sufficiently like that of the normal TA. This implantation might be considered applicable to the reconstruction of the TA in conditions such as trauma or Peyronie＇s disease.展开更多
The precise microscopic feature of carbon-carbon（C/C） composites is essential {or an accurate predic tion of their mechanical behavior. After fabrication, actual microscopic feature differs from simple ideal spatial...The precise microscopic feature of carbon-carbon（C/C） composites is essential {or an accurate predic tion of their mechanical behavior. After fabrication, actual microscopic feature differs from simple ideal spatial model. Micro computed lomography（CT） scan can well describe internal microstruetures of composites. Therefore, a reconstructed model is developed based on mireo-CT, by a series of prodcedures including extrac tlng components, generating new binary images and establishing a finite element （FE） model. Compared with the model designed by reconstructed commercial software MIMICS. the presented reconstructed FE model is superior in terms of high mesh quality and eontrollable mesh cluantity. The precision of the model is verified by experiment.展开更多
Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase o...Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase or invade large calibre vascular structures. This presents a major challenge in terms of safe excision while also leaving acceptable surgical margins. In recent times, the trend has been towards limb salvage with vascular reconstruction in preference to amputation. Newer orthopaedic and vascular reconstructive techniques including both synthetic and autogenous graft reconstruction have made complex limb-salvage surgery feasible. Despite this, limb-salvage surgery with concomitant vascular reconstruction remains associated with higher rates of post-operative complications including infection and amputation. In this review we describe the initial presentation and investigation of patients presenting with soft tissue sarcomas in the pelvis and extremities, which involve vascular structures. We further discuss the key surgical reconstructive principles and techniques available for the management of these complex tumours, drawn from our institution's experience as a national tertiary referral sarcoma service.展开更多
Objective:Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are increasingly being used to treat peritoneal malignancies.Urological resections and reconstruction(URR)are occasionally perfor...Objective:Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are increasingly being used to treat peritoneal malignancies.Urological resections and reconstruction(URR)are occasionally performed during the surgery.We aim to evaluate the impact of these procedures on peri-operative outcomes of CRS and HIPEC patients.Methods:A retrospective review of a prospectively maintained database of all patients who underwent CRS-HIPEC from April 2001 to February 2016 was performed.Outcomes between patients who had surgery involving,and not involving URR were compared.Primary outcomes were the rate of major complications and the duration of stay in the intensive care unit(ICU)and hospital.Secondary outcomes were that of overall survival(OS)and prognostic factors that would indicate a need for URR.Results:A total of 214 CRS-HIPEC were performed,21 of which involved a URR.Baseline clinical characteristics did not vary between the groups(URR vs.No URR).Urological resections comprised of 52%bladder resections,24%ureteric resections,and 24%involving both bladder and ureteric resections.All bladder defects were closed primarily while ureteric reconstructions consisted of two end-to-end anastomoses,one ureto-uretostomy,five direct implantations into the bladder and three boari flaps.URR were more frequently required in patients with colorectal peritoneal disease(p Z 0.029),but was not associated with previous pelvic surgery(76%vs.54%,p Z 0.065).Patients with URR did not suffer more serious complications(14%vs.24%,p Z 0.42).ICU(2.2 days vs.1.4 days,p Z 0.51)and hospital stays(18 days vs.25 days,p Z 0.094)were not significantly affected.Undergoing a URR did not affect OS(p Z 0.99),but was associated with increased operation time(570 min vs.490 min,p Z 0.046).Conclusion:While concomitant URR were associated with an increase in operation time,there were no significant differences in postoperative complications or OS.Patients with colorectal peritoneal metastases are more likely to require a URR compared to other primary tumours,and needs to be considered during pre-operative planning.展开更多
The traditional strategy of 3D model reconstruction mainly concentrates on orthographic projections or engineering drawings. But there are some shortcomings. Such as, only few kinds of solids can be reconstructed, the...The traditional strategy of 3D model reconstruction mainly concentrates on orthographic projections or engineering drawings. But there are some shortcomings. Such as, only few kinds of solids can be reconstructed, the high complexity of time and less information about the 3D model. The research is extended and process card is treated as part of the 3D reconstruction. A set of process data is a superset of 2D engineering drawings set. The set comprises process drawings and process steps, and shows a sequencing and asymptotic course that a part is made from roughcast blank to final product. According to these characteristics, the object to be reconstructed is translated from the complicated engineering drawings into a series of much simpler process drawings. With the plentiful process information added for reconstruction, the disturbances such as irrelevant graph, symbol and label, etc. can be avoided. And more, the form change of both neighbor process drawings is so little that the engineering drawings interpretation has no difficulty; in addition, the abnormal solution and multi-solution can be avoided during reconstruction, and the problems of being applicable to more objects is solved ultimately. Therefore, the utility method for 3D reconstruction model will be possible. On the other hand, the feature information in process cards is provided for reconstruction model. Focusing on process cards, the feasibility and requirements of Working Procedure Model reconstruction is analyzed, and the method to apply and implement the Natural Language Understanding into the 3D reconstruction is studied. The method of asymptotic approximation product was proposed, by which a 3D process model can be constructed automatically and intelligently. The process model not only includes the information about parts characters, but also can deliver the information of design, process and engineering to the downstream applications.展开更多
Introduction:This chapter will provide an overview of factors affecting the cost of office-based procedures in Facial Plastics and Reconstructive Surgery(FPRS),and will discuss the value of office-based interventions....Introduction:This chapter will provide an overview of factors affecting the cost of office-based procedures in Facial Plastics and Reconstructive Surgery(FPRS),and will discuss the value of office-based interventions.Material and Methods:An in-depth literature review was conducted using multiple primary and secondary sources.Literature from multiple disciplines was included in the review,including otolaryngology,anesthesiology,surgery,public health,and economics.Discussion/Conclusions:A wide variety of procedures can be performed in an FPRS office.Large upfront costs to the office include laser,electrocautery and surgical equipment.These investments will yield an initial negative cost margin until sufficient case volume is achieved.It is often in the best interest of the patient to perform a procedure in-office and avoid the facility and anesthesia fees associated with a surgical center or hospital.Costs and reimbursements vary greatly across regions and facilities.Additionally,overall cost depends on payer mix,procedures performed,and productivity of the practice.The scarcity of literature on this topic as it applies specifically to FPRS indicates that further research is needed to elucidate the value of common facial plastics procedures in an office-based setting.展开更多
In this paper, we conduct theoretical analysis and literature review applications on the form innovation design and implementation of secondary reconstruction for cool core fabric. At present, due to the development o...In this paper, we conduct theoretical analysis and literature review applications on the form innovation design and implementation of secondary reconstruction for cool core fabric. At present, due to the development of The Times and the progress of science and technology, people＇ s aesthetic concept also transformed, functional and decorative fabric art aesthetic has been raised to an important level, but also strong. Second fabric design is refers to the use of various traditional and high-tech means to the existing fabric to open out the design of the processing, make its surface rich visual texture and touch skin texture. Our method is effective and novel, we will try to make it into real-world applications in the future.展开更多
目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87...目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87)岁;对照组32例,男18例,女14例,年龄为(63.78±12.98)岁。手术方式均为关节镜下缝线桥技术缝合肩袖。分别记录两组病人术前1周、术后3个月、6个月和12个月各时间点肩关节最大外展角度值,以及肩关节功能评分,包括疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder Elbow Surgeon,ASES)评分、加州大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分以及Constant⁃Murley评分。据此对手术效果进行评估。结果62例病人均未出现伤口感染、术后僵硬、术后再撕裂等并发症。两组病人的肩关节最大外展角度值、VAS评分、ASES评分、UCLA评分以及Constant⁃Murley评分均在术后3个月、6个月和1年得到显著改善(P<0.05)。糖尿病组的肩关节最大外展角度值及各肩关节功能评分在术前1周、术后3个月及6个月时均劣于对照组(P<0.05),但在术后12个月时,糖尿病组与对照组比较,差异无统计学意义(P>0.05)。结论糖尿病对关节镜下肩袖修复术后的病人短期恢复会存在影响,但长期临床结果没有显著差异。围手术期血糖控制良好的糖尿病病人在关节镜下肩袖修复术后表现出与非糖尿病病人相当的临床和结构恢复。展开更多
目的观察采用局部皮瓣修复儿童面部色素痣切除后组织缺损的临床疗效。方法回顾性分析浙江大学医学院附属儿童医院烧伤整形外科2018年1月至2022年1月收治的246例采用局部皮瓣修复的儿童面部色素痣切除后组织缺损患儿临床资料,总结患儿临...目的观察采用局部皮瓣修复儿童面部色素痣切除后组织缺损的临床疗效。方法回顾性分析浙江大学医学院附属儿童医院烧伤整形外科2018年1月至2022年1月收治的246例采用局部皮瓣修复的儿童面部色素痣切除后组织缺损患儿临床资料,总结患儿临床特征、病变位置及大小、皮瓣设计要点及术后外观改善情况。结果246例均皮瓣成活,切口均一期愈合;术后随访9个月至3年,无一例明显瘢痕增生或正常组织牵拉致外观畸形发生,外观改善均满意;246例瘢痕美容评估与评级量表(scar cosmesis assessment and rating,SCAR)评分(3.49±1.58)分,其中62例(62/246,25.2%)评分0~2分,为十分满意;138例(138/246,56.1%)评分3~4分,为比较满意;35例(35/246,14.2%)评分5~7分,为相对满意;11例(11/246,4.5%)评分>7分,为不满意;手术效果总体评分满意率为95.5%(235/246)。结论根据不同的面部美容分区选择合适的局部皮瓣来修复色素痣切除后的皮肤缺损,具有皮瓣成活佳、可避免局部组织牵拉、后期瘢痕不明显等优点,可获得良好的美容效果。展开更多
文摘Data are scarce regarding surgical and non-surgical education in accredited Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowships in theUnited States. We compared surgical and non-surgical and education among training programs and expected surgical comfort level with pelvic reconstructive procedures from the perspective of the fellow and program director. An online survey was distributed to program directors and fellows from the 39 accredited FPMRS fellowships at the time (2010). Domains evaluated in the survey were academic education requirements;surgical approaches to prolapse and to incontinence;other surgical procedures;and research and publication expectations. In total, forty fellows from 21 programs and directors from 27 programs. The most common surgical procedures performed for apical, anterior, and posterior prolapse were uterosacral ligament suspension, native tissue anterior colporrhaphy, and posterior colporrhaphy, respectively. Differences in perceived surgical comfort level were seen for coccygeus suspension, graftreinforced posterior colporrhaphy, rectus fascial sling, urethral bulking agent, cystoscopic ureteral stent placement and bowel repair. A greater proportion of program directors reported that fellows would be comfortable performing these procedures upon graduation than the proportion reported by the fellows themselves. Differences exist in FPMRS training nationwide, however, responding fellows appeared to be trained in multiple approaches to prolapse repair. Differences were seen in surgical comfort level as perceived by fellows and program directors.
文摘Aim： To characterize the feasibility of the surgical replacement of the penile tunica albuginea （TA） and to evaluate the value of a porcine bladder acellular matrix （BAM） graft. Methods： Acellular matrices were constructed from pigs＇ bladders by cell lysis, and then examined by scanning electron microscopy （SEM）. Expression levels of the mRNA of the vascular endothelial growth factor （VEGF） receptor, fibroblast growth factor （FGF）-1 receptor, neuregulin, and brain-derived neurotrophic factor （BDNF） in the acellular matrix and submucosa of the pigs＇ bladders were determined through the reverse transcription-polymerase chain reaction （PCR）. A 5 mm× 5 mm square was excised from the penile TA of nine rabbits. The defective TA was then covered in porcine BAM. Equal numbers of animals were sacrificed and histochemically examined at 2, 4 and 6 months after implantation. Results： SEM of the BAM showed collagen fibers with many pores. VEGF receptor, FGF-1 receptor and neuregulin mRNA were expressed in the porcine BAM; BDNF mRNA was not detected. Two months after implantation, the graft sites exhibited excellent healing without contracture, and the fusion between the graft and the neighboring normal TA appeared to be well established. There were no significant histological differences between the implanted tunica and the normal control tunica at 6 months after implantation. Conclusion： The porcine BAM graft resulted in a structure which was sufficiently like that of the normal TA. This implantation might be considered applicable to the reconstruction of the TA in conditions such as trauma or Peyronie＇s disease.
基金supported by the National Natural Science Foundation of China (Nos.11272147,10772078)the Aviation Science Foundation (No.2013ZF52074)+1 种基金the State Key Laboratory of Mechanical Structural Mechanics and Control (No.0214G02)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)
文摘The precise microscopic feature of carbon-carbon（C/C） composites is essential {or an accurate predic tion of their mechanical behavior. After fabrication, actual microscopic feature differs from simple ideal spatial model. Micro computed lomography（CT） scan can well describe internal microstruetures of composites. Therefore, a reconstructed model is developed based on mireo-CT, by a series of prodcedures including extrac tlng components, generating new binary images and establishing a finite element （FE） model. Compared with the model designed by reconstructed commercial software MIMICS. the presented reconstructed FE model is superior in terms of high mesh quality and eontrollable mesh cluantity. The precision of the model is verified by experiment.
文摘Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase or invade large calibre vascular structures. This presents a major challenge in terms of safe excision while also leaving acceptable surgical margins. In recent times, the trend has been towards limb salvage with vascular reconstruction in preference to amputation. Newer orthopaedic and vascular reconstructive techniques including both synthetic and autogenous graft reconstruction have made complex limb-salvage surgery feasible. Despite this, limb-salvage surgery with concomitant vascular reconstruction remains associated with higher rates of post-operative complications including infection and amputation. In this review we describe the initial presentation and investigation of patients presenting with soft tissue sarcomas in the pelvis and extremities, which involve vascular structures. We further discuss the key surgical reconstructive principles and techniques available for the management of these complex tumours, drawn from our institution's experience as a national tertiary referral sarcoma service.
文摘Objective:Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are increasingly being used to treat peritoneal malignancies.Urological resections and reconstruction(URR)are occasionally performed during the surgery.We aim to evaluate the impact of these procedures on peri-operative outcomes of CRS and HIPEC patients.Methods:A retrospective review of a prospectively maintained database of all patients who underwent CRS-HIPEC from April 2001 to February 2016 was performed.Outcomes between patients who had surgery involving,and not involving URR were compared.Primary outcomes were the rate of major complications and the duration of stay in the intensive care unit(ICU)and hospital.Secondary outcomes were that of overall survival(OS)and prognostic factors that would indicate a need for URR.Results:A total of 214 CRS-HIPEC were performed,21 of which involved a URR.Baseline clinical characteristics did not vary between the groups(URR vs.No URR).Urological resections comprised of 52%bladder resections,24%ureteric resections,and 24%involving both bladder and ureteric resections.All bladder defects were closed primarily while ureteric reconstructions consisted of two end-to-end anastomoses,one ureto-uretostomy,five direct implantations into the bladder and three boari flaps.URR were more frequently required in patients with colorectal peritoneal disease(p Z 0.029),but was not associated with previous pelvic surgery(76%vs.54%,p Z 0.065).Patients with URR did not suffer more serious complications(14%vs.24%,p Z 0.42).ICU(2.2 days vs.1.4 days,p Z 0.51)and hospital stays(18 days vs.25 days,p Z 0.094)were not significantly affected.Undergoing a URR did not affect OS(p Z 0.99),but was associated with increased operation time(570 min vs.490 min,p Z 0.046).Conclusion:While concomitant URR were associated with an increase in operation time,there were no significant differences in postoperative complications or OS.Patients with colorectal peritoneal metastases are more likely to require a URR compared to other primary tumours,and needs to be considered during pre-operative planning.
文摘The traditional strategy of 3D model reconstruction mainly concentrates on orthographic projections or engineering drawings. But there are some shortcomings. Such as, only few kinds of solids can be reconstructed, the high complexity of time and less information about the 3D model. The research is extended and process card is treated as part of the 3D reconstruction. A set of process data is a superset of 2D engineering drawings set. The set comprises process drawings and process steps, and shows a sequencing and asymptotic course that a part is made from roughcast blank to final product. According to these characteristics, the object to be reconstructed is translated from the complicated engineering drawings into a series of much simpler process drawings. With the plentiful process information added for reconstruction, the disturbances such as irrelevant graph, symbol and label, etc. can be avoided. And more, the form change of both neighbor process drawings is so little that the engineering drawings interpretation has no difficulty; in addition, the abnormal solution and multi-solution can be avoided during reconstruction, and the problems of being applicable to more objects is solved ultimately. Therefore, the utility method for 3D reconstruction model will be possible. On the other hand, the feature information in process cards is provided for reconstruction model. Focusing on process cards, the feasibility and requirements of Working Procedure Model reconstruction is analyzed, and the method to apply and implement the Natural Language Understanding into the 3D reconstruction is studied. The method of asymptotic approximation product was proposed, by which a 3D process model can be constructed automatically and intelligently. The process model not only includes the information about parts characters, but also can deliver the information of design, process and engineering to the downstream applications.
文摘Introduction:This chapter will provide an overview of factors affecting the cost of office-based procedures in Facial Plastics and Reconstructive Surgery(FPRS),and will discuss the value of office-based interventions.Material and Methods:An in-depth literature review was conducted using multiple primary and secondary sources.Literature from multiple disciplines was included in the review,including otolaryngology,anesthesiology,surgery,public health,and economics.Discussion/Conclusions:A wide variety of procedures can be performed in an FPRS office.Large upfront costs to the office include laser,electrocautery and surgical equipment.These investments will yield an initial negative cost margin until sufficient case volume is achieved.It is often in the best interest of the patient to perform a procedure in-office and avoid the facility and anesthesia fees associated with a surgical center or hospital.Costs and reimbursements vary greatly across regions and facilities.Additionally,overall cost depends on payer mix,procedures performed,and productivity of the practice.The scarcity of literature on this topic as it applies specifically to FPRS indicates that further research is needed to elucidate the value of common facial plastics procedures in an office-based setting.
文摘In this paper, we conduct theoretical analysis and literature review applications on the form innovation design and implementation of secondary reconstruction for cool core fabric. At present, due to the development of The Times and the progress of science and technology, people＇ s aesthetic concept also transformed, functional and decorative fabric art aesthetic has been raised to an important level, but also strong. Second fabric design is refers to the use of various traditional and high-tech means to the existing fabric to open out the design of the processing, make its surface rich visual texture and touch skin texture. Our method is effective and novel, we will try to make it into real-world applications in the future.
文摘目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87)岁;对照组32例,男18例,女14例,年龄为(63.78±12.98)岁。手术方式均为关节镜下缝线桥技术缝合肩袖。分别记录两组病人术前1周、术后3个月、6个月和12个月各时间点肩关节最大外展角度值,以及肩关节功能评分,包括疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder Elbow Surgeon,ASES)评分、加州大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分以及Constant⁃Murley评分。据此对手术效果进行评估。结果62例病人均未出现伤口感染、术后僵硬、术后再撕裂等并发症。两组病人的肩关节最大外展角度值、VAS评分、ASES评分、UCLA评分以及Constant⁃Murley评分均在术后3个月、6个月和1年得到显著改善(P<0.05)。糖尿病组的肩关节最大外展角度值及各肩关节功能评分在术前1周、术后3个月及6个月时均劣于对照组(P<0.05),但在术后12个月时,糖尿病组与对照组比较,差异无统计学意义(P>0.05)。结论糖尿病对关节镜下肩袖修复术后的病人短期恢复会存在影响,但长期临床结果没有显著差异。围手术期血糖控制良好的糖尿病病人在关节镜下肩袖修复术后表现出与非糖尿病病人相当的临床和结构恢复。
文摘目的观察采用局部皮瓣修复儿童面部色素痣切除后组织缺损的临床疗效。方法回顾性分析浙江大学医学院附属儿童医院烧伤整形外科2018年1月至2022年1月收治的246例采用局部皮瓣修复的儿童面部色素痣切除后组织缺损患儿临床资料,总结患儿临床特征、病变位置及大小、皮瓣设计要点及术后外观改善情况。结果246例均皮瓣成活,切口均一期愈合;术后随访9个月至3年,无一例明显瘢痕增生或正常组织牵拉致外观畸形发生,外观改善均满意;246例瘢痕美容评估与评级量表(scar cosmesis assessment and rating,SCAR)评分(3.49±1.58)分,其中62例(62/246,25.2%)评分0~2分,为十分满意;138例(138/246,56.1%)评分3~4分,为比较满意;35例(35/246,14.2%)评分5~7分,为相对满意;11例(11/246,4.5%)评分>7分,为不满意;手术效果总体评分满意率为95.5%(235/246)。结论根据不同的面部美容分区选择合适的局部皮瓣来修复色素痣切除后的皮肤缺损,具有皮瓣成活佳、可避免局部组织牵拉、后期瘢痕不明显等优点,可获得良好的美容效果。
