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软组织扩张术

软组织扩张术的相关文献在1989年到2022年内共计125篇,主要集中在外科学、临床医学、儿科学 等领域,其中期刊论文124篇、会议论文1篇、专利文献151093篇;相关期刊53种,包括世界科学、天津护理、河南外科学杂志等; 相关会议1种,包括中华医学会第四次全国美容外科学术大会等;软组织扩张术的相关文献由423位作者贡献,包括王佳琦、刘嘉锋、孙家明等。

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软组织扩张术—发文趋势图

软组织扩张术

-研究学者

  • 王佳琦
  • 刘嘉锋
  • 孙家明
  • 郭树忠
  • 马显杰
  • 刘元波
  • 周智
  • 唐勇
  • 庄洪兴
  • 张海明
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 薛涵; 薛仰杰; 李建学; 胡世均; 李翔; 吴若冰
    • 摘要: 目的观察软组织扩张术对烧伤整形患者创面愈合时间及创面恢复血运时间的影响。方法回顾性选择2018年7月至2021年6月亳州市人民医院收治60例烧伤患者,根据治疗方法不同分为两组,每组各30例。观察组予以软组织扩张术治疗,对照组予以复合皮移植治疗。比较两组患者的临床疗效、创面愈合时间、创面恢复血运时间及术后并发症发生情况。结果观察组患者的治疗总有效率为93.33%,明显高于对照组(76.67%),差异有统计学意义(P<0.05)。观察组患者的创面愈合时间、创面皮肤血运恢复时间为(11.91±2.55)、(17.53±3.02)d,明显短于对照组[(17.38±2.71)、(24.19±3.35)d],差异均有统计学意义(P<0.05)。观察组患者的并发症发生率为10.00%,明显低于对照组(26.67%),差异有统计学意义(P<0.05)。结论对烧伤整形患者应用软组织扩张术治疗可提高临床疗效,促进创面愈合,加速创面恢复血运时间,并有助于减少术后并发症。
    • 郭亚东; 李晓晴; 孙要文; 秦高平
    • 摘要: 目的:分析三维激光扫描技术在头部、颈部、胸部及下肢扩张皮肤表面积测量中的应用及与注水量的相关性.方法:回顾性选取60例烧伤整形医学美容外科患者,术后7 d采用三维激光扫描技术在头部、颈部、胸部及下肢扩张皮肤行表面积测量.手术分Ⅰ、Ⅱ期进行,Ⅰ期放置皮肤扩张器,并于术后每周定期行注水处理,注水时间为3个月;Ⅱ期采用三维激光扫描技术并于Geomagic Qualify检测软件下测量扩张皮肤表面积,分析皮肤扩张面积与注水量的相关性.结果:皮肤软组织扩张表面积从小到大依次为大腿内侧、大腿外侧和胸部、额部、颈部、面颊部以及头顶部;扩张部位表面积与其修复部位密切相关;皮肤扩张面积与注水量呈正相关(r=0.57,P<0.01).结论:基于三维激光扫描技术可通过Angel色素分析软件等选择最佳扩张器行皮瓣扩张和手术预构.
    • 董立维; 郝冬月; 夏文森
    • 摘要: Objective This study aimed to present our clinical experience using a novel method for autologus costal cartilage framework fabricationin fully expansion technique ear reconstruction without skin graft.Methods During Steptember 2016 to Steptember 2017,autologus costal cartilage framework with expansion technique were performed for 63 patients with microtia.Autologous costal cartilage was stacked up to form the structure and height,the natural appearance of auriculocephalic angle was achieved at the same stage,so the second-stage elevation of ear and postauricular skin graft was unnecessary.The delicate structure of the reconstructed ear and ideal bilateral symmetry were achieved by the optimized cartilage stack-up.Results Three patients out of total 63 patients had cartilage frame work exposure,and were treated with superficial temporal fascia transfer combined with skin graft.The rest 60 patients had satisfied results.Follow-up ranged from 8 months to 18 months and 12 months follow-up was on average.The novel frame work fabrication method was based on the sufficient full pre-expansion procedure.The ideal structure,bilateral symmetry,and excellent definition of the framework,as well as the natural dorsal appearance of the reconstructed auricular were achieved.Conclusions The cartilage " stack-up" method is essential for the full expansion without skin grafts ear reconstruction technique.The combination of the cartilage " stack-up" framework fabrication and full pre-expansion provide a well-defined,well-projected and bilateral symmetrical ear.%目的 探讨完全扩张法耳再造术中应用软骨层叠塑形雕刻软骨支架的临床效果.方法 2016年9月至2017年9月西京医院整形外科行完全扩张法耳再造术63例,男44例,女19例,年龄7~26岁.术中取自体肋软骨雕刻支架塑形,雕刻方法以软骨层叠塑形为主要原则,同时通过软骨层叠建立支架自身高度,使颅耳沟一次成形;通过软骨合理层叠后形成的三维结构再造耳廓精细结构;再造耳廓塑形时要注意解剖结构的表现和对称性.结果 3例出现软骨支架外露,予清创换药、颢筋膜瓣结合游离植皮覆盖创面植皮后愈合;余60例患者再造耳廓外形满意.随访时间8~18个月,平均12个月.术后耳廓成形效果理想,耳前、后形态均得以表现,双侧对称性好.结论 在耳再造术软骨支架雕刻中,将软骨层叠塑形结合充分预扩张,可获得再造耳廓解剖结构的体现及同期塑造耳后形态的良好效果.
    • 张倜然; 陈红波; 陈弋华; 刘立强; 范金财; 甘承; 田佳; 杨增杰; 焦虎; 张桦
    • 摘要: Objective To introduce a reconstruction procedure of natural sideburn,with combined expanded retroauricular flap and scalp flap.Methods A retrospective study was produced in Plastic Surgery Hospital,PUMC,from January 2014 to December 2017.Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap,n=3;single pedicled flap,n=17) were included in this study.There were 12 male (12 sides) and 8 female (9 sides),with the mean age of (23.8±3.2) years.The sideburn defect was caused by burn in 19 patients,and it was resulted from hemangioma in 1 patient.Results The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm.Venous congestion at the distal end of the flap occurred in 1 patient,which was cured after dressing change,and the sideburn was not affected.The reconstructed sideburns are natural,symmetric,and without obvious scar.The follow-up time was 3-40 months.Fourteen patients were very satisfied with the reconstructed sideburn,and 6 patients were satisfied.No severe complication was observed during follow-up time.Conclusions The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction,which provide natural hair distribution,inconspicuous scars and less complications.%目的 探讨应用耳后皮肤和头皮联合扩张皮瓣重建自然美观的鬓角的临床效果.方法 回顾性分析中国医学科学院整形外科医院整形九科2014年1月至2017年12月接受耳后皮肤和头皮联合扩张皮瓣鬓角再造术的患者的临床资料,共20例,男12例(12侧),女8例(9侧),年龄(23.8±3.2)岁.其中烧伤后鬓角缺失19例,鬓角区血管瘤1例.采用扩张的耳后皮肤联合头发瓣通过单蒂或双蒂转移至耳前进行鬓角再造.结果 人组的20例患者共再造21侧鬓角,术中切取皮瓣面积8 cm ×12 cm~10 cm×16 cm,其中1例术后皮瓣远端发生静脉淤血,经过积极换药处理痊愈,鬓角形态未受影响,其余皮瓣均成活良好,重建的鬓角外观自然,并且与健侧鬓角形态、位置基本对称.皮瓣供区瘢痕隐藏于新形成的耳后发际线中.术后随访3~40个月,其中14例非常满意,6例比较满意.结论 耳后皮肤头皮联合扩张皮瓣转移重建的鬓角,具有完全正常的毛发皮肤分界线,毛发密度及生长方向符合自然鬓角的结构,且瘢痕隐蔽,患者满意度高.
    • 蒋永能; 王会军; 赵炳瑜; 鲁冰; 李耀
    • 摘要: 目的 探讨皮肤软组织扩张术在颈部瘢痕中应用的临床效果.方法 2009年3月至2018年5月新疆克拉玛依市中心医院烧伤整形科收治15例颈部烧伤后瘢痕患者,男12例,女3例,年龄12~48岁,平均31岁,瘢痕面积9 cm×6 cm~14 cm×11 cm.一期手术在颈部瘢痕一侧或两侧附近正常皮肤区域皮下埋置100~300 ml的皮肤软组织扩张器.术后10~ 14 d注入生理盐水进行扩张,每次间隔10d,扩张3~9个月.扩张后静置1个月左右,行二期手术,取出扩张器,切除颈部瘢痕,将扩张皮瓣转移修复缺损创面.结果 15例中2例扩张后期因摩擦出现扩张器轻度外露,予以碘伏纱布包扎,未影响最终治疗效果;其余13例扩张皮瓣血运良好.扩张皮瓣大小为12 cm×8 cm ~16 cm× 15 cm,二期术后皮瓣全部成活.术后随访0.5~5年,皮瓣色泽、质地与邻近正常皮肤相近,临床修复效果满意.结论 皮肤软组织扩张术修复颈部瘢痕,安全可靠,效果显著.%Objective To investigate the clinical outcomes of skin and soft tissue expansion in the repairment of neck scar.Methods From March 2009 to May 2018,15 patients with postburn scar contractures on neck,were admitted to the Department of Burn and Plastic Surgery,Karamay Central Hospital of Xinjiang.The patients include 12 males and 3 females,aged 12 to 48 years,with the mean age of 31 years.The scars were at 9 cm×6 cm-14 cm×11 cm in size.The tissue expander of 100-300 ml was placed subcutaneously,in the normal skin area on neck,on one or each side at the first stage operation.The first expander infusion was performed 10-14 days after surgery.The tissue expansion remains for 3-9 months,with an interval of 10 days of each infusion.After the tissue fully expanded,the expander was maintained for 1 month.At the second stage,the expander was removed,and the expanded flap was transferred to repair the wound.Results The expander exposure due to friction occurred in 2 patients.The final therapeutic effect was not affected,because of iodine gauze bandage.Blood supply of expanded flaps was good in other patients.The size of the expanded flaps was 12 cm×8 cm-16 cm× 15 cm.All flaps survived after the second stage surgery.Patients were followed up for 0.5-5 years after surgery.The color and texture of flaps was similar to adjacent normal skin.Conclusions Skin and soft tissue expansion is a safe and effective method in repairing neck scar.
    • 夏成德; 薛继东; 狄海萍; 曹大勇; 韩大伟; 谢江帆; 王丽敏; 牛希华
    • 摘要: Objective To investigate the clinical outcome of expanded frontotemporal flap pedicled with bilateral superficial temporal vessels,in repairing facial and cervical scar contracture deformity.Methods From January 2012 to December 2017,12 male patients with severe facial and cervical scar hyperplasia and contracture deformity,ranging from preauricular region,cheek,chin to neck,were treated in the Burn Department of the First People's Hospital in Zhengzhou.The patients were aged at 15-58 years,with the mean age of 29.3 years.The frontotemporal scalp flaps were simultaneously expanded to prefabricate a flap pedicled with bilateral superficial temporal arteries and veins.The operations were carried out in 3 stages.Stage Ⅰ:A 400-600 ml cylindrical expander was placed in the frontal region,underneath of galea aponeurosis and frontal muscle,meanwhile,a 50-100 ml cylindrical expander was placed in the temporal region on each side,between the deep temporal fascia and temporal muscle.Stage Ⅱ]:The expanded flap pedicled with bilateral superficial temporal vessels were received,to repair the secondary wound after scar resection and contracture release.The neck curve was reshaped.The donor area was directly sutured.Stage Ⅲ:The flap pedicle was repaired,and residual scar was removed.Laser hair removal was performed on the skin flaps about 3 weeks after operation.Results Seven patients underwent simultaneously cervical and thoracic tissue expansion.The expansion time was 5-6 months (average 5.2 months).The expanded flap was 40 cm×9 cm to 45 cm× 15 cm in size.Allflaps survived.The venous reflux disorder after the second stage operation occurred in 1 patient.The affected area was purple and swollen.It was recovered after acupuncture and compression bandage for 1 week.Laser hair removal was performed in 8 flaps.Flap thinning was performed in 5 flaps.All 12 patients were followed up for 4 to 24 months.The flaps have good appearance,without bloating.The transferred flaps have similar color and texture with adjacent the facial skin.The cervical mobility was significantly improved.The hairline of the head was normal,and the suture scar was slight and concealed.Conclusions The expanded frontal and temporal flaps provide considerable amount of tissue with thin skin and reliable blood supply.It is an alternative method to repair facial and cervical scar contracture.%目的 探讨以双侧颞浅血管为蒂的额颞部扩张皮瓣修复面颈部瘢痕挛缩畸形的临床效果.方法 2012年1月至2017年12月,郑州市第一人民医院烧伤科收治12例面颈部严重瘢痕增生、挛缩畸形男性患者,包括耳前、面颊、颏颈部大面积瘢痕,年龄15~58岁,平均29.3岁.对额部、颞部头皮同期扩张,形成以双侧颞浅动、静脉血管为蒂的额颞部扩张皮瓣进行修复.手术分三期进行:(1)一期手术于额顶部置入400~600 ml圆柱形扩张器1枚,置入层次在帽状腱膜及额肌下,两侧颞部各置入50~ 100 ml圆柱形扩张器1枚,置入层次在颞深筋膜与颞肌之间.(2)二期切取以双侧颞浅血管为蒂的扩张皮瓣,转移修复颌颈部瘢痕切除及挛缩松解后的继发创面,重塑颈部曲线,供瓣区直接拉拢缝合.(3)三期行皮瓣断蒂修整及剩余瘢痕切除修复术.术后3周左右对皮瓣行激光脱毛处理.结果 本组12例患者,其中7例联合颈胸部皮肤同期扩张.注水扩张时间5~6个月,平均5.2个月,扩张后切取皮瓣面积40 cm×9 cm~45 cm×15 cm,12例皮瓣转移后均成活,其中1例二期术后皮瓣出现静脉回流障碍,呈现紫色、肿胀,给予针刺放血、按压处理,1周后完全恢复.8例皮瓣进行激光脱毛处理,5例因皮瓣臃肿进行了修薄.12例患者随访4 ~ 24个月,皮瓣外观良好,无臃肿,色泽、质地与面部皮肤相近.颈部活动度明显改善,头部发际线正常,缝合口瘢痕轻微且隐蔽.结论 额、颞部皮肤扩张后能够提供较大面积的薄皮瓣,血运可靠,是修复面颈部瘢痕挛缩较佳的方法.
    • 张宝帅; 赵素焱; 郝胜利
    • 摘要: 皮肤软组织扩张术在整形外科领域,尤其是在乳房重建、烧伤整形方面起到了重要的作用.表浅皮肤软组织的缺损可以采用皮瓣或游离植片来修复,然而在眼部重建手术中,由于肿瘤切除或外伤导致的组织缺损,需要提供大面积的皮肤软组织进行修复,传统的转位皮瓣或游离植片常无法完成修复.皮肤软组织扩张术能够提供肤色、质地及厚度匹配的皮肤软组织,扩张后的皮肤软组织可以通过各种形式的滑行或旋转修复眼睑和眶周组织的缺损,这已成为治疗各种眶周缺损极为重要的方法.然而该技术在眼科应用过程中仍存在扩张周期较长,扩张皮肤软组织晚期挛缩较严重,转移皮瓣远端部分缺血坏死等关键问题未能解决,从而严重影响修复效果.本文对皮肤软组织扩张术在眼整形外科的适应证及常见并发症进行综述,以期望对临床有所帮助.
    • 于海生; 陆思锭; 覃朝; 蒙旭昌; 韩志强
    • 摘要: 目的 探讨颞浅血管蒂头皮扩张皮瓣修复面部大面积皮肤病变及缺损的临床效果.方法 2014年12月至2016年10月,广西医科大学第一附属医院整形美容外科采用颞浅血管蒂头皮扩张皮瓣移植联合激光脱毛,治疗10例不同程度大面积面部病变缺损患者,男4例,女6例,年龄19~35岁.采集患者颞顶部扩张后头皮组织标本作为试验组;另收集10例其他整形手术患者术中去除的多余颞顶部、面颊、上下眼睑、额部、鼻背正常皮肤组织作对照组.对2组皮肤厚度进行比较,并随访6个月到1年.结果 扩张后头皮瓣与面部周围皮肤组织色泽、质地基本匹配,面部轮廓、形态及美学效果满意.颞顶部扩张头皮厚度与面颊部、额部、鼻背部皮肤厚度比较,差异无统计学意义(P>0.05),与上、下睑部皮肤厚度比较差异有统计学意义(P<0.05).结论 颞浅血管蒂头皮扩张皮瓣移植是修复面部大面积皮肤缺损的较好方法,但在修复上、下睑皮肤缺损时,效果仍有一定不足.%Objective To investigate the therapeutic outcome of expanded scalp flaps pedicled with superficial temporal vessel for the reconstruction of large facial defects.Method From Dec 2014 to Oct 2016,10 cases with large facial skin defects were treated with expanded scalp flaps pedicled with superficial temporal vessel and delayed laser hair removal.Extra expanded scalp flaps were collected as experimental groups.Normal skin(forehead,temporal scalp,cheek,upper eyelid,lower eyelid and nasal dorsum)of 10 cases were collected for control,to compare skin thickness.All patients were followed at least 6 months.Results There was no significant difference of skin thickness between the expanded scalp flaps and cheek,forehead,nasal dorsum skin(P> 0.05).But upper eyelid and lower eyelids skin was significantly thinner than other local skin tissuein controls,and expanded scalp flap (P<0.05).The expanded scalp flap matched well with surrounding tissues in color,texture and thickness.Conclusions It is a good option to repair large facial skin defects with expanded scalp flaps,pedicled with superficial temporal vessel,and laser hair removal,though its shortcoming in eyelid skin defect repairment.
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