国际皮肤性病学杂志
國際皮膚性病學雜誌
국제피부성병학잡지
INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY
2015年
1期
1-3
,共3页
赵亮%张倩%陆鑫锋%王焱%布文博%吴信峰%方方
趙亮%張倩%陸鑫鋒%王焱%佈文博%吳信峰%方方
조량%장천%륙흠봉%왕염%포문박%오신봉%방방
皮肤肿瘤%外科手术%皮肤移植%方法
皮膚腫瘤%外科手術%皮膚移植%方法
피부종류%외과수술%피부이식%방법
Skin neoplasms%Surgical procedures,operative%Skin transplantation%Methods
目的 探讨一种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,供皮创面可直接拉拢缝合关闭.方法 运用数学原理,在面积相等的原则下,设计两个半圆相切排列的供皮法,所取的两个半圆皮片经拼接后即可形成一较大面积皮片,满足修复大面积皮肤缺损的需要.用该方法治疗9例皮肤恶性肿瘤患者,其中头、面部3例,足部6例,包括鳞状细胞癌3例,恶性黑素瘤6例.皮损面积1 cm×2 cm至6 cm×9 cm不等,切除后创面缺损面积为5 cm×6 cm至8 cm×9.5 cm.结果 供皮宽度缩小后,供皮区缺损能够直接拉拢缝合,同时也避免了供皮区皮源的浪费.头面部3例患者中,2例全部成活,1例边缘少许糜烂;6例足底部患者约有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,相切法等面积供皮是一种较好的选择.
目的 探討一種新的供皮區取皮方法,在穫取較大麵積全厚皮片的同時,可縮短供皮區寬度、減少縫閤張力,供皮創麵可直接拉攏縫閤關閉.方法 運用數學原理,在麵積相等的原則下,設計兩箇半圓相切排列的供皮法,所取的兩箇半圓皮片經拼接後即可形成一較大麵積皮片,滿足脩複大麵積皮膚缺損的需要.用該方法治療9例皮膚噁性腫瘤患者,其中頭、麵部3例,足部6例,包括鱗狀細胞癌3例,噁性黑素瘤6例.皮損麵積1 cm×2 cm至6 cm×9 cm不等,切除後創麵缺損麵積為5 cm×6 cm至8 cm×9.5 cm.結果 供皮寬度縮小後,供皮區缺損能夠直接拉攏縫閤,同時也避免瞭供皮區皮源的浪費.頭麵部3例患者中,2例全部成活,1例邊緣少許糜爛;6例足底部患者約有10％ ～ 20％壞死,經換藥處理,1～2箇月後愈閤.結論 脩複較大麵積皮膚缺損,相切法等麵積供皮是一種較好的選擇.
목적 탐토일충신적공피구취피방법,재획취교대면적전후피편적동시,가축단공피구관도、감소봉합장력,공피창면가직접랍롱봉합관폐.방법 운용수학원리,재면적상등적원칙하,설계량개반원상절배렬적공피법,소취적량개반원피편경병접후즉가형성일교대면적피편,만족수복대면적피부결손적수요.용해방법치료9례피부악성종류환자,기중두、면부3례,족부6례,포괄린상세포암3례,악성흑소류6례.피손면적1 cm×2 cm지6 cm×9 cm불등,절제후창면결손면적위5 cm×6 cm지8 cm×9.5 cm.결과 공피관도축소후,공피구결손능구직접랍롱봉합,동시야피면료공피구피원적낭비.두면부3례환자중,2례전부성활,1례변연소허미란;6례족저부환자약유10％ ～ 20％배사,경환약처리,1～2개월후유합.결론 수복교대면적피부결손,상절법등면적공피시일충교호적선택.
Objective To develop a new method to gain large-sized full-thickness skin grafts,which allows the direct closure of donor defects by shortening the width of donor area and reducing suture tension.Methods According to mathematical principles,a method was developed to design two semicircular skin grafts which were tangentially joined to form a skin graft whose size was approximately equal to that of a large skin defect.This method was applied to treat 9 patients with cutaneous malignancy,including 3 cases of squamous cell carcinoma and 6 cases of malignant melanoma.Lesions were located on the head or face in 3 patients and in the foot region in 6 patients.The size of lesions varied from 1 cm × 2 cm to 6 cm × 9 cm,and the size of defects after resection of lesions varied from 5 cm × 6 cm to 8 cm × 9.5 cm.Results The width of donor areas was decreased by using this method,and donor defects were directly closed with the avoidance of waste of donor skin.Two out of three patients with carcinoma on the head or face achieved complete survival of skin grafts,and one experienced mild erosion at the margin of skin grafts.Skin graft necrosis (10％-20％) was observed in foot soles of 6 patients,which healed 1-2 months after dressing changes.Conclusion Equal-sized donor grafts formed by tangential joining of two semicircular skin grafts are a good choice for the repair of relatively large skin defects.
