吻合血管游离皮瓣移植后皮肤再扩张的实验研究

在应用耳后皮肤扩张行耳廓再造的手术中，为了解决耳后皮肤不正常，如烧伤后耳后有瘢痕不能行皮肤扩张的问题，我们设计了吻合血管游离皮瓣移植后皮肤再扩张的手术方式，为证实手术设计的可行性，在兔体上进行此术式的动物实验。用兔双侧胸背部皮肤，一侧作原位吻合血管游离皮瓣移植后，再扩张；另一侧作常规的皮肤扩张。从扩张容量、扩张中有无并发症、皮肤血管的变化和组织学观察等方面比较两组之间均无显著性差异（Ｐ＞０．０５）。表明，在兔体上吻合血管游离皮瓣移植后再皮肤扩张对皮肤扩张无明显不良影响，为临床应用提供参考。

EXPERIMENTAL STUDY OF SKIN EXPANSION OF THE GRAFTED FREE VASCULARIZED SKIN FLAP

By using retro auricular skin after skin expansion to reconstruct auricle, oftentimes, the retro auricular skin could not be expanded because of certain reasons such as having burn scar. For this purpose, a new operative technique was designed. The experiment consisted of using 15 rabbits, on one side of the back, a free vascularized skin flap was obtained. Following the anastomosis of the vessels of the flap with that of the back the flap was sutured back in situ. Two weeks after the removal of the sutures, the grafted skin flap was expanded as usual. The routine skin expansion was carried out on the contralateral side as control. The volume of expansion, change of subcutaneous blood vessels, complications from operation, and histological observation were used to compare the results of skin expansion of the two sides. The result showed that there was no significant difference between the types of skin expansion. It was concluded the grafted free vascularized skin flap had no adverse effect on skin expansion.