不同方法治疗耳郭瘢痕疙瘩35例

目的 探讨不同手术方法治疗耳郭瘢痕疙瘩的疗效。方法 首先锐性切除耳郭瘢痕疙瘩,瘢痕较软者,尽量保留蒂部表皮,然后对于不同部位、不同形状的瘢痕疙瘩,采取拉拢缝合、滑行或旋转皮瓣、游离植皮修复,部分患者局部注射曲安奈德20～40 mg, 5例术后1～3 d内放疗。结果 全部患者随访1～9年,痊愈29例(82.9%),其中 1例耳垂向后移位,并形成切迹,但瘢痕疙瘩未复发,仍计入痊愈病例。好转3例(8.6%),无效3例(8.6%)。结论 不同部位、形状的耳郭瘢痕疙瘩,在切除瘢痕疙瘩后,可以采取直接拉拢缝合、旋转皮瓣或植皮的方法修复皮肤缺损。局部可注射曲安奈德,整齐对合切口,术后抗感染,及时放疗可以有效减少复发。

Different methods to treat auricular keloids (35 cases report)

Objective To investigate the effectiveness of different methods to treat auricular keloids. Methods After the auricular keloids were sharply dissected, the epidermides at pedicle were reserved as much as possible when the keloids were soft. Then, the skin defects were sutured directly or repaired with sliding flap, rotation flap or free skin graft according to their locations and shapes. Triamcinolone 20-40 mg was injected in some patients. Radiotherapy was performed in 5 cases one to three days after the surgery. Result After 1-9 years follow-up, 29 cases(82.9%) showed completely free of lesion. An auricular lobule was pulled back with angel formed after surgery, however, no lesion was noted. There were another 3 cases(8.6%) of moderate improvement and 3 cases(8.6%) of recurrence. Conclusion After excising auricular keloids, skin defects can be sutured directly or repaired with sliding flap, rotation flap or free skin graft according to their locations and shapes. Triamcinolone, delicate suture, postoperative anti-infection and immediate radiotherapy help reduce the recurrence.