低位引流与切口引流对耳后扩张器置入后并发症的影响

目的探讨低位引流与切口引流对耳后扩张器置入术后并发症的影响。方法选取自2018年1月至2019年7月收治80例单侧先天性小耳畸形患者,随机分成A、B两组,每组各40例,均采用耳后乳突区置入50 ml扩张器。手术切口均为耳后发际中段内1 cm,置入平面为筋膜下,注射壶外置。经手术切口引流组(A组),手术切口处放置引流,使引流管与扩张器导管一并从切口处引出,切口分层缝合。低位引流组(B组),在剥离腔隙最低位下1 cm做一小切口,经该切口放置负压引流管引流,扩张器注射壶经切口引出。结果A组中3例发生血肿,3例感染,2例切口裂开,引流管放置时间平均为7 d。B组中无一例发生血肿、切口裂开,2例发生感染,引流管放置时间平均为4 d。瘢痕面积B组小于A组,两组比较差异具有统计学意义(P<0.05)。结论低位引流可缩短引流时间,明显降低耳后扩张器置入术后并发症的发生率,有效预防手术切口瘢痕增生。

Effect of low drainage and incision drainage on complications after post-auricular expander implantation

Objective To explore the effect of lowdrainage and incision drainage on complications after post-auricular expander implantation.Methods From January 2018 to July 2019,80 patients with unilateral congenital ear malformation treated in our department were selected.All patients were randomly divided into group A and B.Expander of 50 ml was implanted in the mastoid region behind the ear.All surgical incisions were inside 1 cm of the middle hairline behind the ear.The implantation plane was under the fascia and the injection pot was external fixed.In group A,the drainage was placed at the surgical incision in 40 patients.The drainage tube and expander catheter were drawn from the incision.The incision was sutured in layers.In group B,a small incision at 1 cm belowthe lowest position of the stripped cavity was made in 40 patients.A negative pressure drainage tube was placed through this incision,and the injection pot of the expander was drawn through the incision.Results In group A,there were 3 cases of hematoma,3 cases of infection and 2 cases of wound dehiscence.The average duration of drainage tube placement was 7 days.In group B,no hematoma and wound dehiscence occurred.There were 2 cases of infection.The average duration of drainage tube placement was 4 days.The scar area of group B was smaller than that of group A,and the difference between 2 groups was statistically significant(P<0.05).Conclusion The lowdrainage could significantly reduce the drainage time and the incidence rate of complications after post-auricular expander implantation.This method could effectively prevent scar hyperplasia of the surgical incision.