手法取皮游离移植修复头颈部缺损123例

目的探讨手术刀手法取皮游离移植在头颈部缺损修复中的应用价值。方法回顾性分析1985～2004年123例头颈部肿瘤术后缺损手法取皮游离移植即期修复的临床资料，其中修复头皮、眼睑、外鼻、面部等皮肤缺损88例；修复上腭、颊粘膜、咽腔、上颌窦等黏膜缺损35例。结果修复皮肤缺损的88例皮片全部成活，成活率100％(88／88)；修复黏膜缺损的35例皮片中，全部成活者23例，占65．91％(23／35)；部分成活者9例，占25．71％(9／35)；皮片坏死者3例，占8．57％(3／35)。术后随访6～12个月，受皮区由凹陷变的近于正常者108例，外形及功能恢复满意，供皮区愈合后无功能障碍及不适。结论手法取皮游离移植，设备简单易于操作，损伤小，是修复头颈部缺损，尤其是皮肤缺损的较理想方法。

Experience of Skin Transplant by Hand to Reconstruct the Head and Neck Defects 123 Cases

Objective To investigate the application of getting all and thick skin slice to transplant by operation knife in the reconstruction of the head and neck defects.Methods To analyze 1985~2004 clinical data using operation knife to get skin to transplant to reconstruct the head and neck defects of totally 123 cases.There are 88 cases to reconstruct scalp,eyelid and so on.There are 35 cases to reconstruct maxilla,cheek.Pharynx and so on.Results The 88 skin slices to reconstruct skin defect are alive,survival ratio 100%(88/88).There are 23 cases all alive in the 35 skin slices to reconstruct mucosa.That is 65.91%(23/35);There are 9 cases whose skin slice are mostly alive.That is 25.71%(9/35);There are 3 cases whose skin slice are dead.That is 8.57%(3/35).To observe the skin area after operation about 6~12 months.108 cases gradually become normal,no function obstacles about the skin area who offer skin.Conclusion The skin transplant by hand is an ideal way to reconstruct head and neck defects,especial for skin defects.Because the equipment is simple and harm is small and it is easy to operate.