手术扩大切除联合全厚植皮治疗面部皮肤鳞状细胞癌的效果观察*

目的：探讨手术扩大切除联合全厚植皮治疗面部皮肤鳞状细胞癌的临床效果。方法：收集2013年1月—2017年12月在南通大学附属医院皮肤科诊断为面部皮肤鳞状细胞癌的患者68例，均采用手术扩大切除联合全厚植皮的方法进行治疗，术后观察皮片存活率、肿瘤复发率等指标。结果：68例患者均在术中完整切除肿瘤组织，病理结果示切缘及底部未见肿瘤组织残留。术后皮片坏死面积：<5.0% 63例(92.6%)、5.0%~10.0% 4例(5.9%)、>10.0%~20.0% 1例(1.5%)。术后随访1年，肿瘤局部复发5例(7.4%)，未发现远处转移。结论：手术扩大切除联合全厚植皮治疗面部皮肤鳞状细胞癌，术后皮片存活率高，外观效果满意，且肿瘤复发率较低，具有良好的临床疗效。

Clinical observation of curative effect of extended resection combined with full thickness skin grafting in the treatment of facial cutaneous squamous cell carcinoma*

Objective : To observe the prognosis of patients with facial cutaneous squamous cell carcinoma and analyze the curative effect of extended resection combined with full-thickness skin grafting in the treatment of facial cutaneous squamous cell carcinoma. Methods : A total of 68 patients with facial cutaneous squamous cell carcinoma diagnosed in the department of dermatology of Affiliated Hospital of Nantong University from January 2013 to December 2017 were collected. The patients were treated with the method of expanded resection combined with full-thickness skin grafting. Postoperative skin graft survival rate, tumor recurrence ratewere observed. Results : All the 68 patients underwent complete resection of tumor tissue, and the pathological results showed that no tumor tissue remained in the resection margin and basilar part. Among the 68 patients, 63 patients(92.6%) had skin graft necrosis area less than 5%, 4 patients(5.9%) had skin graft necrosis area between 5% and 10%, and 1 patient(1.5%) had skin graft necrosis area between 10% and 20%. Local recurrence was found in 5 patients(7.4%) and no metastasis was detected. Conclusion : In the treatment of facial cutaneous skin squamous cell carcinoma by resection combined with full thickness skin grafting, the survival rate of skin graft is high, the appearance is satisfactory, and the recurrence rate of tumor is low, which has good curative effects.