头皮扩张术修复瘢痕性秃发

目的：总结头皮扩张术治疗瘢痕性秃发的临床应用经验与教训。方法：回顾1988年1月至2000年12月应用头皮扩张术修复瘢痕性秃发136例。统计秃发面积，扩张容量，修复面积，修复效果，并发症及其原因。结果：本组秃发区大于100cm^2者67例，平均面积103cm^2，共放置容量为140ml-450ml扩张器261个，一次性完全修复秃发者120例，10例经一次头皮接力扩张术或延期再扩张术后完全修复。6例遗留较小面积秃发区。平均4ml扩张容量能修复1cm^2秃发面积。并发症发生率为22％。手术并发症为14．7％，扩张器质量并发症7．3％，影响手术效果的并发症为7．3％。结论：皮肤组织扩张术是修复瘢痕性秃发较理想的方法，平均4ml扩张容量能修复1cm^2秃发面积。提高扩张器质量，重视提高外科基本操作技能可降低头皮扩张术较高并发症的发生率。

REPAIR FOR SCAR BALDNESS BY SCALP EXPANDING TECHNIQUE

To summary the experience and lesson in clinical application of scalp expanding technique for treatment of scar baldness Methods:136 cases with scar baldness treated by scalp expanding technique from January of 1988 to December of 2000 were reviewed and summarized according to baldness area,expanded volume,repaired area,operation result,compliaction and its cause Results:The average baldness area was about 103cm 2 including 67 cases with baldness areas more than 100cm 2 Totally,261 soft tissue expanders with volume sizes from 140ml to 450ml were used,and the baldness areas were completely repaired in 120 cases after one expanding operation,while re expanding needed in 10 cases There were small baldness areas left in 6cases after all repair operations for this group of patients The statistical results showed that about 4ml of expanded volume could satisfy the cover requirement for 1cm 2 of baldness area The complication incidence rate was about 22%,in which 14 7% caused by operation mistakes and 7 3% by expander quality not up to standard,while about 7 3% of the complications affected the final repair results Conclusions:The tissue expanding techniqueis a comparatively ideal way for the repair of scar baldness,of which about 4ml of expanded volume would be needed for per 1cm 2 Improving the expander quality,less using re expanding to the utmost,and emphasizing the importance of basic surgical techniques might reduce the complication incidence rate in scalp expanding operation