CAJ | 학술논문

目的探讨新的供皮区取皮方法,在获取较大面积全厚皮片的同时,可缩短供皮区宽度、减少缝合张力,缺损面可直接缝合闭合.方法运用数学原理,在面积相等的条件下,设计错位供皮法,所取的皮片经拼接后即可形成较大面积皮片,满足修复大面积缺损的需要.用该方法治疗7例皮肤恶性肿瘤患者,头、面部5例,足部2例,包括基底细胞癌3例,鳞状细胞癌3例,恶性黑素瘤1例.结果供皮宽度缩小后,供皮区缺损能够直接拉拢缝合,同时也避免供皮区皮源的浪费.7例患者,头面部5例中,3例全部成活,2例边缘少许糜烂；2例足底部约10％～20％坏死,经换药处理,1～2个月后愈合.结论修复较大面积皮肤缺损,拼接法等面积供皮是一种较好的选择.
목적 탐토신적공피구취피방법,재획취교대면적전후피편적동시,가축단공피구관도、감소봉합장력,결손면가직접봉합폐합.방법 운용수학원리,재면적상등적조건하,설계착위공피법,소취적피편경병접후즉가형성교대면적피편,만족수복대면적결손적수요.용해방법치료7례피부악성종류환자,두、면부5례,족부2례,포괄기저세포암3례,린상세포암3례,악성흑소류1례.결과 공피관도축소후,공피구결손능구직접랍롱봉합,동시야피면공피구피원적낭비.7례환자,두면부5례중,3례전부성활,2례변연소허미란；2례족저부약10％～20％배사,경환약처리,1～2개월후유합.결론 수복교대면적피부결손,병접법등면적공피시일충교호적선택.
Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.