头面颈部毛细血管畸形的手术治疗

目的 探讨手术治疗头面部不同类型毛细血管畸形的适应证,手术方法及疗效.方法 对适合手术的23例头面颈部患者,根据病灶的面积和手术前的条件分别采用了植皮,扩张器局部皮瓣转移修复和游离皮瓣修复等方法,并进行术后评价和随访.结果 除一例特别原因造成皮片下积血,皮片部分成活不良二期再植,一例同位素治疗后扩张器病例远端发生血运障碍后改植皮以外,其余皮片,皮瓣均成活良好,但随访皮片有较明显的色差,而皮瓣色泽,质地良好.结论 皮瓣修复效果较好,其中扩张的局部皮瓣转移修复效果最佳.游离皮瓣较适合有皮下组织萎缩的大面积的病例,而其他大面积病灶可采用分期分区植皮.

Surgical Therapy of Capillary Malformation in Head, Face and Neck

Objective To study the indication, surgical methods and outcomes of different kinds capillary malformation in head, face and neck. Methods 23 patients adapted to surgery were treated by the skin-grafting, expanded flap and free flap according to the size and the condition of lesions, respectively. Result The grafted skins and flaps survived well besides of extreme necrosis of one expanded flap, which was then repaired by second skin-grafting. All the flaps had good appearance and texture contrast to grafted skin. Conclusion The lesions treated with flap were achieved with satisfactory cosmetic outcomes, we recognized that the local expanded flap is better with their minimal invasion if they could be. Free flap were adapted to the large lesions with subcutaneous atrophy by isotope treatment before and skin grafting were used to the other large lesions by several stages.