应用扩张后皮瓣修复颏部瘢痕

目的探讨应用扩张后皮瓣修复颏部瘢痕的美容效果。方法单纯颏部瘢痕或伴小面积面部瘢痕者，采用颏部、颌底、面部皮肤扩张，扩张器置入时，不要超过颌颈角；否则，扩张器只是将颌颈角填平，不能充分有效扩张皮肤。对于面颊、颏、颈部瘢痕的修复，局部无可供扩张的正常皮肤时，则采用胸三角皮瓣预扩张，扩张充分后带蒂转移修复面部瘢痕，3周后断蒂修复颏、颈部瘢痕。结果26例应用局部及远位扩张后皮瓣修复颏部瘢痕，皮瓣成活良好，术后效果满意。结论应用扩张后的局部或远位皮瓣修复颏部瘢痕，是目前较好的治疗方法。

Treatment for mentalis scars with expanded skin flaps

Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.