应用局部皮瓣治疗会阴区瘢痕挛缩

目的：探讨各种原因引起的会阴区瘢痕挛缩的修复方法。方法：1991年1月－2000年1月共治疗会阴区瘢痕挛缩20例分别采用局部皮瓣转移术＋游离皮片移植，皮瓣移植术修复。如会阴周围有可供利用的正常皮肤，最好首先采用扩张术，将正常皮肤扩张后形成局部皮瓣加游离皮片移植修复。功能重要区域如耻骨联合，阴囊部可采用轴型皮瓣修复。结果：20例会阴区瘢痕，其中一次手术修复18例，近期效果满意。10例患者获得随访仍有部分功能障碍，需再次手术修复。结论：会阴区瘢痕挛缩的治疗，功能重要区域采用轴型皮瓣修复，其他区域以局部皮瓣加游离皮片移植修复为佳。

LOCAL FLAP IN TREATMENT OF THE CONTRACTURE OF THE PERINEAL SCARS

Objective: To investigate method for repairing the contracture of the perineal scars due to various causes. Methods: 20 patients with scar contrcture in the perineal area were treated in our hospital from Jan. 1991 to Jan. 2000. Freee skin grafting + local skin flap transposition and skin flap transposition were used. Where normal skin was available, dilation'should first be applied to dilate the normal skin which then formed local skin flap and together with the additional free skin to repair the contracture. In such vital functional areas as pubic symphysis and scrotum, axial flaps were used. Results: Of the 20 patients with scar contracture in the perineal area, 18 showed short - term satisfactory effect as the skin and flap completely survived after only one operation. 10 were followed up and found with some functional defects, so further operation is required to repair the contracture . Conclusion: For the treatment of scar contracture in the perineal area, axial flaps can be used in the vital functional areas while local skin flaps and free skin graft are preferable for other areas.