CAJ | 학술논문

目的探讨采用强脉冲光对扩张的带毛发的头皮进行脱毛的操作方法和相关参数,以及其在大容量扩张器全扩张法耳廓再造术中的应用效果.方法 2009年2月至2013年9月,对126例采用大容量的扩张器(100 ml或150 ml)进行耳廓再造的患者,在扩张器埋置术后注水期及扩张静止期采用强脉冲光进行头皮部分的毛发脱除,记录脱毛参数、操作方法、时间间隔和脱毛的效果及其并发症.二期取自体肋软骨行全扩张法耳廓再造.结果强脉冲光脱毛参数:能量20 ～ 35J/cm2,平均25.3 J/cm2,脉宽26～ 30 ms,平均27.9 ms,间隔4周行下一次脱毛.并发症:皮肤红斑5例,皮肤水泡1例,皮肤色素沉着7例,未发生因脱毛致皮肤坏死及扩张器外露等并发症.二期手术前脱毛治愈率为76.2％ (96/126),总有效率达96.8％(122/126).术后6～12个月三期耳修整时,脱毛治愈率为73.0％(92/126),总有效率达92.9％ (117/126).结论在扩张器注水期及静止期采用强脉冲光对扩张皮肤的毛发脱除,效果明显,并发症少,可为耳廓再造提供足够的无毛发区域,再造耳外观明显改善.
목적 탐토채용강맥충광대확장적대모발적두피진행탈모적조작방법화상관삼수,이급기재대용량확장기전확장법이곽재조술중적응용효과.방법 2009년2월지2013년9월,대126례채용대용량적확장기(100 ml혹150 ml)진행이곽재조적환자,재확장기매치술후주수기급확장정지기채용강맥충광진행두피부분적모발탈제,기록탈모삼수、조작방법、시간간격화탈모적효과급기병발증.이기취자체륵연골행전확장법이곽재조.결과 강맥충광탈모삼수:능량20 ～ 35J/cm2,평균25.3 J/cm2,맥관26～ 30 ms,평균27.9 ms,간격4주행하일차탈모.병발증:피부홍반5례,피부수포1례,피부색소침착7례,미발생인탈모치피부배사급확장기외로등병발증.이기수술전탈모치유솔위76.2％ (96/126),총유효솔체96.8％(122/126).술후6～12개월삼기이수정시,탈모치유솔위73.0％(92/126),총유효솔체92.9％ (117/126).결론 재확장기주수기급정지기채용강맥충광대확장피부적모발탈제,효과명현,병발증소,가위이곽재조제공족구적무모발구역,재조이외관명현개선.
Objective To investigate the application of intense pulsed light(IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.Methods From February 2009 to September 2013,one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia.During the skin expanding,the hair on the expanded skin was depilated by IPL technique.The parameter,operation,interval,the depilation result and the complication were recorded.The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.Results The energy of IPL was 20-35 J/cm2 (mean 25.3 J/cm2),the width of pulse was 26-30 ms (mean 27.9 ms),the interval between two operations was 4 weeks.Ninety-six patients were cured(76.2％,96/126).The total depilation efficient is 96.8％ (122/126).A fine banding blisters was found in one patient whose depilation areas was marked by black pen.Skin euthema was found in five patients and skin pigmentation was found in 7 patients.There were no skin necrosis and expander exposure in all patients.During 6-12 months of follow-up period,ninety-two patients were cured (73.0％,92/126) and the total depilation efficient is 92.9％ (117/126).Conclusions IPL depilation during the skin expanding is feasible and safe with careful procedure.The hairless expanded skin is enough to cover the framework,as well as the post-auricular area.The appearance of reconstructed ear is better without hair.