CAJ | 학술논문

目的观察双侧胸三角区扩张皮瓣修复面颈部重度瘢痕的效果.方法 2009年4月至2012年2月,解放军第三○九医院收治9例面颈部烧伤瘢痕患者,其中男5例,女4例；年龄23～48岁,平均33岁；瘢痕位于面部5例、颈部4例；瘢痕形成时间均在半年以上,面积12 cm×7 cm～22 cm×26 cm.均在胸三角区置入600～ 800 ml扩张器,利用双侧胸三角区皮瓣扩张形成薄皮瓣同时修复双侧面颈部瘢痕.面部瘢痕修复分4次手术,颈部瘢痕修复分2次手术.供瓣区均直接拉拢缝合.术后2周观察瘢痕修复面积、皮瓣的成活情况及皮瓣质地、颜色及有无臃肿等.术后半年来院复查并调查患者对手术的满意度,以后每半年邮件随访1次.结果 1例患者左侧皮瓣术后淤血经换药后愈合.其他8例患者术后皮瓣成活良好.所有患者随访6～ 30个月.2例患者术后皮瓣臃肿,半年后行皮瓣修整手术.其他患者术后皮瓣质地柔软,无臃肿,未行皮瓣修整.所有患者面颈部形态显著改善,患者满意度评分(7.6±2.3)分,对手术效果均满意.结论双侧胸三角区扩张薄皮瓣修复面颈部重度瘢痕效果理想.
목적 관찰쌍측흉삼각구확장피판수복면경부중도반흔적효과.방법 2009년4월지2012년2월,해방군제삼○구의원수치9례면경부소상반흔환자,기중남5례,녀4례；년령23～48세,평균33세；반흔위우면부5례、경부4례；반흔형성시간균재반년이상,면적12 cm×7 cm～22 cm×26 cm.균재흉삼각구치입600～ 800 ml확장기,이용쌍측흉삼각구피판확장형성박피판동시수복쌍측면경부반흔.면부반흔수복분4차수술,경부반흔수복분2차수술.공판구균직접랍롱봉합.술후2주관찰반흔수복면적、피판적성활정황급피판질지、안색급유무옹종등.술후반년래원복사병조사환자대수술적만의도,이후매반년유건수방1차.결과 1례환자좌측피판술후어혈경환약후유합.기타8례환자술후피판성활량호.소유환자수방6～ 30개월.2례환자술후피판옹종,반년후행피판수정수술.기타환자술후피판질지유연,무옹종,미행피판수정.소유환자면경부형태현저개선,환자만의도평분(7.6±2.3)분,대수술효과균만의.결론 쌍측흉삼각구확장박피판수복면경부중도반흔효과이상.
Objective To contrive an effective method of repairing the scar in bilateral faciocervical region.Methods Between April 2009 and February 2012,9 patients with large scars on face and neck due to burn and scald were treated.There were 5 cases with face scars and 4 cervical scars.Their average age was 33 years (range:23-48 years).The disease duration was 6 months to 20 years (mean:6.5 years).The scar area was 12 cm ×7 cm to 22 cm× 26 cm.The soft tissue expanders (600-800 ml in volume)were implanted in delto-pectoral zone in one-stage operation.In two-stage operation,after the resection of cervical scars,the defects were repaired with delto-pectoral perforator flaps.In 5 facial scar cases,skin flap pedicle division was performed at Week 3.After the resection of scars,all wounds were repaired by expansion flap.The donor sites were sutured directly.The area of removed scar and the status of flap blood supply were observed.And the texture of flaps and patient satisfaction score were followed up for 6-30 months.Results Mild congestion of flap occurred postoperatively 1 case.The other flaps survived successfully.The flaps of 2 cases appeared bulky after transposition and flap repair was performed at Month 6.The appearance,texture,and color of flaps were similar to those at the donor sites.And there was an excellent match of flaps and recipient place.The patient satisfaction score was 7.6 ± 2.3.All achieved satisfactory functional and aesthetic outcomes.Conclusion The method has many advantages and its clinical application is both safe and effective.