皮肤软组织扩张术在眼整形外科的应用进展

摘要： 皮肤软组织扩张术在整形外科领域， 尤其是在乳房重建、 烧伤整形方面起到了重要的作用。表浅皮肤软组织的缺损可以采用皮瓣或游离植片来修复， 然而在眼部重建手术中， 由于肿瘤切除或外伤导致的组织缺损， 需要提供大面积的皮肤软组织进行修复， 传统的转位皮瓣或游离植片常无法完成修复。皮肤软组织扩张术能够提供肤色、 质地及厚度匹配的皮肤软组织， 扩张后的皮肤软组织可以通过各种形式的滑行或旋转修复眼睑和眶周组织的缺损， 这已成为治疗各种眶周缺损极为重要的方法。然而该技术在眼科应用过程中仍存在扩张周期较长， 扩张皮肤软组织晚期挛缩较严重， 转移皮瓣远端部分缺血坏死等关键问题未能解决， 从而严重影响修复效果。本文对皮肤软组织扩张术在眼整形外科的适应证及常见并发症进行综述， 以期望对临床有所帮助。

Progress in the application of skin soft tissue expansion inophthalmic plastic and reconstructive surgery

Abstract: Soft tissue expansion plays an important role in the field of plastic surgery, especially in breast reconstruction and burn plastic surgery. The superficial skin and soft tissue defects can be repaired with full-thickness skin flaps as well as free grafts. However, in ocular reconstruction surgery, large area of tissue defects caused by tumor resection or trauma need to be repaired by large area of skin and soft tissue. Traditional transposition skin flaps or free grafts can not complete the repair. Skin and soft tissue expansion can provide excellent skin and soft tissue matching skin color, texture and thickness. Expanded skin and soft tissue can repair eyelid and periorbital tissue defects by sliding or rotating in various forms. This technique provides a valuable surgical alternative for managing various periorbital defects. However, this technique still has a long expansion period in the application of ophthalmology, and the late contracture of the soft tissue of the expanded skin is severe, and the key problems such as the ischemic necrosis of the distal part of the metastatic flap cannot be solved, thus seriously affecting the repair effect. This article reviews the indications and common complications of skin soft tissue expansion in ophthalmic plastic surgery in order to be helpful to clinic practice.