全头皮撕脱伤的中厚皮瓣自体植皮治疗

目的总结采用中厚皮瓣自体植皮结合人工皮覆盖及网状植皮治疗全头皮撕脱伤的体会。方法对3例因长发被卷入高速转动的机器而致全头皮撕脱伤的40—48岁女性患者，入院后即行自体头皮中厚皮瓣植皮，对颅骨外露处作颅骨外板密集钻孔及人工皮覆盖，待肉芽组织覆盖后行聚乙烯泡沫衬垫网状植皮。结果3例患者均获痊愈，遗留秃发，未发生骨髓炎等并发症。结论对头皮条件较差的全头皮撕脱伤患者，中厚皮瓣自体植皮不失为一种有效的治疗措施。人工皮覆盖可加快肉芽组织的生长，聚Z．烯泡沫衬垫网状植皮简便。

Total Scalp Avulsion Treated by Split Skin Replantation (a Report of 3 Cases)

Objective To summarize the experiences in treating total scalp avulsion with split skin replantation. Methods Three patients with total scalp avulsion （female, 40-48 years old） with large skull exposure were treated with split skin replantation. Many little apertures were made and reticulate split skin graft was performed on the external layer of the exposed skulls. Results All the patients were recovered smoothly. There were no serious complications except for bare head. Conclusions Split skin replantation, drilling little apertures on the external layer of the exposed skulls and artificial skin sucking-covering and reticulate split skin grafting should be used in combination with each other for total scalp avulsion when the avulsed skin flap was not Suitable for vaseular anastomosis.