耳再造术中自体肋软骨切取的手术要点及相关问题分析

目的 探讨耳再造术中自体肋软骨切取手术的设计原则及操作要点.方法 回顾总结自2013年3月至2014年2月,403例耳再造术中自体肋软骨切取手术的设计方案及操作过程,强调对目标肋软骨的触诊,以确定手术切口位置;合理设计切口位置,采用合适的手术器械使切口最小化;根据整体手术流程,决定肋软骨切取次序,避免成为影响手术进度的瓶颈环节;防止切口周缘的过度损伤,对创缘进行适当处理后,采用美容缝合技术关闭伤口.结果 最小化手术切口的同时,采用美容缝合技术处理伤口,所有患者均恢复良好,切口Ⅰ期愈合,患者对胸部小切口满意.合理的切取顺序加快了整体手术进度,从而缩短了手术时间.结论 结合手术需求,准确定位目标肋软骨位置,合理设计并采用合适的手术器械,是手术切口最小化的重要条件;合理的切取次序能够优化手术流程,有助于缩短手术时间.

Surgical procedure of autologous costal cartilage harvest for ear reconstruction and analysis of relevant issues

Objective To investigate the surgical procedure of autologous costal catilage harvest for erar re construction and analyze the relevant issues,in order to set up a standard operation procedure.Methods From March 2013 to Feburay 2014,totally 403 patients with autologous costal cartilage harvest for ear reconstruction were reviewed.Palpation of the target costal catilage and suitable surgical instrunent were important for an appropriate approach of incision.Sequence of harvest should be determined by the procedure of erar reconstruction.Aesthetic suture technique was introduced for wound closure.Results All the patients received good wound healing,and were satisfied with minimized and aesthetic sutured incision.Appropriate sequence of harvest reduced the total time of surgery.Conclusion Detailed evaluation of target costal cartilage and suitable surgical instrument were important to minimize the incision,which with the combination of aesthetic suture technique led to good degree of satisfaction of patient.Emphasizing the sequence of harvest could significantly reduce the time cost of surgery.