皮肤软组织扩张术临床应用经验总结

目的:回顾总结皮肤软组织扩张术临床应用23年的经验,以进一步改善并提高该技术的治疗效果。方法:1984年11月至2007年6月对包括秃发、鬓角缺损、头皮撕脱伤、眼爆炸伤、下唇颏部瘢痕、鼻、耳再造等5000例次病例运用皮肤软组织扩张术进行修复治疗。通过基础研究和临床资料的回顾性分析,总结该技术应用的要点和注意事项,并进一步完善其应用中存在的缺陷。结果:术后效果证实该技术有较多的优点,对烧、创伤后畸形的修复,秃发、耳、鼻等器官再造,以及肿瘤切除后的修复,明显优于皮片移植及一般皮瓣治疗的效果。针对该技术存在周期较长并有较多并发症的缺点,23年来进行了逐步的完善,临床应用情况提示我们在具体应用时,应注意的关键问题是争取更多更好"的额外"皮肤软组织。在此基础上要注意完善设计思想,重视操作细节等。结论:掌握该技术的客观规律,重视整体设计思想,注重操作的细节,此技术的应用必将更为广泛并成为整形外科应用的先进技术。

The experience of tissue expansion

Objective To review the 23 years experience of tissue expansion application, for the further improvement and refine the result with this method. Methods Edit the basic research finding and the clinical experiences into the book "Skin and soft tissue expansion: new edition ". Introduce the main viewpoints in this article. Results With the prove of laboratory research and the application in 5000 cases from Nov. 1984 to Jun. 2007, the expansion technique possesses many advantages. Especially for the repair of post burn and trauma deformities, alopecia, ear and nose reconstruction, and the lesion post tumor excision, tissue expansion is significant superior to skin graft and flap transposition. According to the disadvatages such as high complication rate and prolonged expansion time, many experiences were gained. The focus should be to get more and better "extra skin". Careful design and operation is the key to better results. Representative cases are introduced here. Conclusion Understanding the mechanism, overall designing and paying attention to the details are keys to get better results. The tissue expansion technique will be the advanced technique in plastic surgery.