CAJ | 학술논문

目的探讨皮瓣修复创面的美学效果.方法 2004年1月-2011年12月,笔者单位收治需行创面修复的1996例患者(共计2082个创面),包括503个深度烧伤创面、268个溃疡压疮、392个外伤性皮肤软组织缺损创面、479个体表肿瘤及痣切除术后皮肤软组织缺损创面、314个瘢痕切除松解术后皮肤软组织缺损创面、126个其他类型创面.创面大小为1.5 cm× 1.0 cm～30.0 cm×22.0 cm.把握创面修复时机,按照皮瓣修复原则,应用局部皮瓣、带蒂皮瓣、扩张皮瓣、游离皮瓣修复上述各类创面.结果术后48 h内5个皮瓣发生静脉回流障碍,其中2个皮瓣经局部按摩好转;1个皮瓣经局部应用肝素并静脉放血后成活;1个皮瓣经急诊手术取栓、大隐静脉桥接重新吻合后成活;1个皮瓣发生局部坏死,重新植皮后愈合.其余移植皮瓣成活良好.1321例患者术后随访3个月～2年,皮瓣形态良好,色泽、弹性近似正常.部分患者经过后期瘢痕整形,达到预期效果.结论灵活应用皮瓣修复创面不仅愈合速度快、功能恢复好,同时可以获得较好的美学效果.
목적 탐토피판수복창면적미학효과.방법 2004년1월-2011년12월,필자단위수치수행창면수복적1996례환자(공계2082개창면),포괄503개심도소상창면、268개궤양압창、392개외상성피부연조직결손창면、479개체표종류급지절제술후피부연조직결손창면、314개반흔절제송해술후피부연조직결손창면、126개기타류형창면.창면대소위1.5 cm× 1.0 cm～30.0 cm×22.0 cm.파악창면수복시궤,안조피판수복원칙,응용국부피판、대체피판、확장피판、유리피판수복상술각류창면.결과 술후48 h내5개피판발생정맥회류장애,기중2개피판경국부안마호전;1개피판경국부응용간소병정맥방혈후성활;1개피판경급진수술취전、대은정맥교접중신문합후성활;1개피판발생국부배사,중신식피후유합.기여이식피판성활량호.1321례환자술후수방3개월～2년,피판형태량호,색택、탄성근사정상.부분환자경과후기반흔정형,체도예기효과.결론 령활응용피판수복창면불부유합속도쾌、공능회복호,동시가이획득교호적미학효과.
Objective To investigate the aesthetic effect of wound repair with flaps. Methods One thousand nine hundred and ninety-six patients with 2082 wounds hospitalized from January 2004 to December 2011.These wounds included 503 deep burn wounds,268 pressure sores,392 soft tissue defects caused by trauma,479 soft tissue defects due to resection of skin cancer and mole removal,314 soft tissue defects caused by scar excision,and 126 other wounds.Wound area ranged from 1.5 cm × 1.0 cm to 30.0 cm×22.0 cm.Sliding flaps,expanded flaps,pedicle flaps,and free flaps were used to repair the wounds in accordance with the principle and timing of wound repair with flaps. Results Five flaps showed venous congestion within 48 hours post-operation,2 flaps of them improved after local massage.One flap survived after local heparin wet packing and venous bloodletting.One flap survived after emergency surgical embolectomy and bridging with saphenous vein graft.One flap showed partial necrosis and healed after skin grafting.The other flaps survived well.One thousand three hundred and twenty-one patients were followed up for 3 months to 2 years,and flaps of them were satisfactory in shape,color,and elasticity,similar to that of normal skin.Some patients underwent scar revision later with good results. Conclusions Application of suitable flaps in wound repair will result in quick wound healing,good function recovery,and satisfactory aesthetic effect.