皮肤恶性肿瘤手术治疗与美容修复的临床研究

目的：探讨皮肤恶性肿瘤病灶彻底切除后美容修复的可行性。方法：按照无瘤技术完整切除肿瘤病灶,根据创面部位、大小、深度,遵照＂宁近勿远,宁简勿繁＂的原则,选择适宜的皮瓣、肌皮瓣或皮片修复创面;创面位于功能部位者采用分区植皮技术。术后根据肿瘤性质,选择放射治疗、化学治疗或免疫治疗等辅助治疗;伤口局部给予康复治疗。结果：基底细胞癌、鳞状细胞癌和恶性黑色素瘤仍是常见的皮肤恶性肿瘤,占本组198例患者的85.6%,共169例。实施皮片移植137例,其中全厚植皮62例,中厚植皮75例,111例实施分区植皮,皮片成活率均在95%以上;61例采用皮瓣或肌皮瓣修复创面,均100%成活;所有病例创面修复后外形均良好。160例患者得到6个月以上随访,15例死亡（6例死于其他疾病）,16例发生局部复发或远处转移,其余患者术区外形良好,局部无复发。结论：按照无肿瘤技术彻底切除皮肤恶性肿瘤后,采用美学理论和整形美容技术修复创面可以达到美容修复的目的。

Clinical study on surgical treatment and cosmetic repair of skin malignant tumor

Objective To probe the feasibility of cosmetic repair after skin malignant tumor being thoroughly excised.Methods A focus was excised totally using no-tumor technique,then according to the site,area and depth of wound and the principle of rather near than further,rather simple than complicated,a flap or a musculocutaneous flap or skin graft was employed to repair the wound.If the wound located on function site,zonation grafting technique would be used.Radiotherapy,chemotherapy or immuno therapy was selected...