【摘要】 目的探讨多个扩张器在治疗头部皮肤软组织缺损中的临床应用。方法 2010年9月至2015年9月,应用头皮扩张皮瓣修复头部组织缺损24例,其中男14例,女10例;年龄8~50岁,平均26岁。急诊患者4例,均为外伤性缺损,病程1~10 h,创面大小为3 cm×6 cm~8 cm×10 cm;平诊患者20例,外伤性瘢痕愈合9例,烫伤瘢痕愈合11例,病程1~20年,创面大小为3 cm×8 cm~7 cm×18 cm。结果 1例患者急诊置入2个扩张器,其中一个扩张器感染取出,另一个扩张器代偿扩张最终修复创面,其余所有扩张器顺利扩张,转移皮瓣后修复创面,皮瓣无坏死,创面I期愈合。术后24例均获随访,随访时间6~24月,平均12月。所有患者均无瘢痕性秃发,其中2例毛发生长顺序有变,旋转皮瓣早期感觉麻木,6月后恢复保护性感觉。结论多个头皮扩张皮瓣联合应用可修复头部外伤性缺损或瘢痕性秃发,该手术操作简便,血供可靠,提供了颜色、质地相似的组织,手术方式灵活,供区及受区外观均获得满意效果。更多还原

【Abstract】 Objective To explore the clinical application of multiple skin expanders on the treatment of soft tissues defect in head skin. Methods From September,2010 to September,2015,the cephalic tissues defect was repaired with scalp expansion flap in 24 cases,in which 14 patients were male and the others were female. The age ranged from 8 to 50 years old and the mean age was 26 years old. Four cases with traumatic defect were emergency patients whose wound size was from 3 cm × 6 cm to 8 cm × 10 cm and the clinical course was 1 to 10 hours. Twenty cases were ordinary patients including 9 patients with traumatic cicatrices and 11 patients with scalded cicatrices. The course of disease was 1 to 20 years and the wound surface was 3 cm × 8 cm to 7 cm ×18 cm. Results All the skin expanders had the satisfactory therapeutic effects except one case suffered from infection to move one of expanders. No patient was lost to follow- up. Patients were followed for 6 to 24 months and the mean time was 12 months. No cicatrical alopecia was shown. The changes in hair growth and early numb sensation of rotation skin flap in two cases were indicated and restored the protective sensation after 6 months.Conclusion Multiple dilators could be used to repair tissues defect in head skin or cicatrical alopecia. This operation was simple and flexible with well blood suppy and providing the similar color and quality to the texture of the tissues in the donor site and recipient site.更多还原