CAJ | 학술논문

目的：探讨先天性小耳畸形皮肤扩张法耳廓再造术I期术后并发症的预防及处理方法。方法对2012年6月1日至2013年5月31日在我科行耳后扩张器置入术的353例患者共368只扩张器进行回顾，其中血肿5例，感染4例，切口裂开4例，扩张皮瓣破溃扩张器外露14例，分别给予清除血肿，放置引流冲洗扩张囊腔，切口重新缝合，换药后限期手术等处理。结果5例血肿患者清除血肿后如期完成手术，4例感染患者及4例切口裂开患者经过处理后，扩张延期7-10天，均完成了Ⅱ期手术，14例扩张皮瓣破溃者处理后限期完成手术。结论I期术后尽管会发生各种并发症，经过恰当及时的处理后，均能得到控制，未对II期手术造成严重影响。
목적：탐토선천성소이기형피부확장법이곽재조술I기술후병발증적예방급처리방법。방법대2012년6월1일지2013년5월31일재아과행이후확장기치입술적353례환자공368지확장기진행회고，기중혈종5례，감염4례，절구렬개4례，확장피판파궤확장기외로14례，분별급여청제혈종，방치인류충세확장낭강，절구중신봉합，환약후한기수술등처리。결과5례혈종환자청제혈종후여기완성수술，4례감염환자급4례절구렬개환자경과처리후，확장연기7-10천，균완성료Ⅱ기수술，14례확장피판파궤자처리후한기완성수술。결론I기술후진관회발생각충병발증，경과흡당급시적처리후，균능득도공제，미대II기수술조성엄중영향。
Object To study prevention and management of complications caused by the tissue expander used behind the ear in patients with congenital microtia. Methods We reviewed data from patients with congenital microtia treated from June 1st 2012 to May 31st 2013 with post-auricular tissue expanders. A total of 368 expanders were used in 353 patients. Complications included necrosis of expanded post-auricular skin flaps (n=14), hematoma (n=5), infections (n=4), and rup-ture of wound (n=4). Timely intervention was implemented and included debridement, profuse irrigation and re-suturing of the wound with drains and follow up wound care. Results The Stage II procedure was not delayed in the 5 patients with hemato-ma after debridement. Skin expansion was extended by 7-10 days before Stage II procedure in the 4 patients with local infec-tion and the 4 patients with wound rupture. All complications had resolved before Stage II procedure after timely and appropri-ate treatment. Conclusion Complications caused by the post-auricular tissue expander are common. Choice of appropriate op-erative techniques, careful post-operative observation and timely management can help reduce complications and consequenc-es, and ensure successful treatment.