面部瘢痕晚期美容修复的原则、方法与技术

目的:探讨面部瘢痕晚期修复的原则、方法与技术。方法:对我中心1993年1月至2004年12月间3091例面部瘢痕病例晚期修复的时机、方法、效果进行回顾性的分析与总结。结果:晚期修复的时机分别为伤后(或上一次手术后)6个月～12年,视具体情况分别采取了瘢痕切除后直接缝合、分次切除术、Z成形术、V-Y成形术、W成形术等局部皮瓣,磨削及充填术,少数病例采用了植皮术、扩张术。经随诊有2%的效果仍不满意。结论:面部瘢痕的晚期美容修复需:①掌握正确的处理原则,手术时机需半年以上且瘢痕已软化后;②选择正确的修复方法与技术;③术后综合处理预防瘢痕增生。通过这些措施可对面部瘢痕进行较好的美容修复,从而达到医患均比较满意的效果。

The principle and technique of late aesthetic revision of facial scar

Objective To analyze the principle and technique of late aesthetic revision of facial scar. Methods Retrospectively reviewed the revision timing, method and result of 3091 facial scar cases from January,1993 to December,2004. Results The revision time varies from 6 month to 12 years.According to the scar,different methods were employed, included excision, serial excision, "Z" plasty, V-Y plasty, W plasty, skin scrub or filling, skin graft and tissue expansion.Among all those cases,the results of 2% cases were still unsatisfactory. Conclusion The main experiences include 1. understanding the principle of scar revision, the surgery time should be more than 6 month post injury while the scar become soften,2. choose correct revision method and technique, and 3. post surgery scar prevention treatment are crucial to satisfactory results.