CAJ | 학술논문

目的：总结唇颏部损伤急诊处理与美容修复的经验。方法回顾性总结2004年9月～2014年12月收治的137例185处唇颏部损伤患者的临床资料，男性89例，女性48例，年龄1～52岁，平均12.2岁。遵照医学美学和整形美容外科原则，不刻意强调清创时机，采用高压冲洗技术彻底清创；若无皮肤软组织缺损，采用新的缝合技术分层严密缝合，针距和边距0.2cm；若有皮肤软组织缺损，按照“宁近勿远，宁简勿繁”的修复原则，分别选择各种皮瓣修复；注重康复治疗。结果本组137例185处伤口，139处不伴组织缺损的伤口美容缝合后伤口一期愈合；38处伴组织缺损的伤口，以29个局部皮瓣、9个皮下蒂皮瓣和3个黏膜瓣修复，各组织瓣均100％成活，伤口一期愈合；5处延期修复的伤口，2处直接缝合，3处伴组织缺损者以局部皮瓣修复，伤口均一期愈合。所有伤口外形均良好，患者满意。术后3～12个月随访121例167处伤口，绝大多数瘢痕较轻，效果良好。结论在唇颏部损伤急诊处理中，遵照＂创伤美容修复＂理念，充分运用美学理论和整形美容外科技术，实施及时准确的治疗，即能实现美容修复的目标。
목적：총결진해부손상급진처리여미용수복적경험。방법회고성총결2004년9월～2014년12월수치적137례185처진해부손상환자적림상자료，남성89례，녀성48례，년령1～52세，평균12.2세。준조의학미학화정형미용외과원칙，불각의강조청창시궤，채용고압충세기술철저청창；약무피부연조직결손，채용신적봉합기술분층엄밀봉합，침거화변거0.2cm；약유피부연조직결손，안조“저근물원，저간물번”적수복원칙，분별선택각충피판수복；주중강복치료。결과본조137례185처상구，139처불반조직결손적상구미용봉합후상구일기유합；38처반조직결손적상구，이29개국부피판、9개피하체피판화3개점막판수복，각조직판균100％성활，상구일기유합；5처연기수복적상구，2처직접봉합，3처반조직결손자이국부피판수복，상구균일기유합。소유상구외형균량호，환자만의。술후3～12개월수방121례167처상구，절대다수반흔교경，효과량호。결론재진해부손상급진처리중，준조＂창상미용수복＂이념，충분운용미학이론화정형미용외과기술，실시급시준학적치료，즉능실현미용수복적목표。
Objective To summarize the experience of emergency cosmetic repair of injuries in lip and chin regions.Methods The clinical data of 137 cases (89 males and 48 females;185 wounds)of lip and chin in-juries who were admitted in our hospital from Sep.2004 to Dec.2014 were retrospectively analyzed,age ranged from 1-52 years with the average age of 12.2 years.The principles of medical aesthetics and plastic and cosmetic surgery were followed without emphasizing on the debridement timing.A high pressure irrigation technique was employed for thorough debridement.Wounds without skin and soft tissue defect were sutured accurately according to tissue zona-tion with a new suture technique,and the needle distance and the edge distance were 0.2cm.Wounds with skin and soft tissue defect were repaired by various flaps according to the repair principle of "rather near than further,rather simple than complicated".Attention was paid to rehabilitation care.Results Of 185 wounds in 137 cases,139 wounds without tissue defect healed on the first stage after being sutured cosmetically.Thirty-eight wounds with tis-sue defect were repaired by 29 local flaps,9 subcutanous pedicle flaps and 3 mucosa flaps.Among 5 wounds under-going delayed repair,2 were directly sutured and 3 with soft tissue defect were repaired with local flaps.All flaps survived and the wounds healed on the first stage.The appearance of all wounds was good and patients were satis-fied.A total of 167 wounds from 121 cases were followed up for 3-12 months.Most cases were in satisfactory con-dition without obvious cicatrix. Conclusion In the emergency treatment of injuries in lip and chin regions, the principle of "cosmetic repair of trauma"should be followed, and the theory of aesthetics combined with the tech-niques of plastic and cosmetic surgery should be applied in cosmetic repair.