扩张器在头额部皮肤缺损修复中的应用

摘要

BACKGROUND: Repair of scalp and forehead skin defects caused by postburn scars or congenital factors is a fairly challenging problem in plastic surgery.OBJECTIVE: To explore a better method than the traditional operative method for scalp and forehead reconstruction with good aesthetic and functional results.DESIGN: A controlled study comparing the preoperative and postoperative findings.SETTING and PARTICIPANTS: Seventy-two consecutive patients (including 33 male and 39 female patients, aged from 4 to 45 years) who had congenital or acquired skin defects on the scalp and forehead, hospitalized in Plastic Surgery Hospital, Peking Union Medical College, were selected in the study.METHODS: Retrospective analysis was conducted for the 72 patients who were treated with skin expander.MAIN OUTCOME MEASURES: The results of skin defect reconstruction and incidences of complications were evaluated in these cases.RESULTS: According to the types of the defects, different treatments were adopted. Complications occurred in 12 cases accounting for a total incidence of 16.7%, including infections, hematoma, exposure or deflation of the expander and hair loss.CONCLUSION: Skin expansion for scalp and forehead skin defect reconstruction can obtain satisfactory aesthetic and functional results by careful preoperative design, improving surgical skills and effective prevention of complications.%背景:烧伤后瘢痕或先天性疾病引起头额部皮肤缺损修复是整形外科较为棘手的问题.目的:探讨扩张器在头额部皮肤缺损修复中优于传统手术疗效的方法. 设计:前后对照研究.地点和对象:中国医学科学院中国协和医科大学整形外科医院收治的先天性和获得性头额部皮肤缺损患者72例,男33例,女39例;年龄4～45岁.方法:对72例头额部的先天性和获得性缺损应用扩张器修复病例进行回顾性总结.主要观察指标:①术后头额部缺损修复情况.②并发症发生率.结果:根据不同缺损采用相应的处理方法,12例出现并发症,发生率16.7%.主要包括感染、血肿、扩张器外露或不张和毛发缺失.均获满意疗效.结论:在充分做好术前设计、提高手术技巧和严防并发症发生的情况下,对头额部缺损的修复,皮肤组织扩张术可取得满意的效果.