皮肤软组织扩张术在儿童复杂瘢痕治疗中的应用

目的：总结皮肤软组织扩张技术治疗儿童复杂瘢痕过程中的经验,以指导临床工作。方法：应用扩张器分Ⅱ期或Ⅲ期扩张皮肤软组织,以旋转、推进、轴型或岛状皮瓣方式转移扩张皮瓣,治疗复杂性瘢痕患儿22例共25处。结果：共埋置扩张器113个,一次修复最大面积20cm×18cm。扩张器感染外露4个,扩张器漏水3个,注射壶翻转3个。在扩张成功的109个皮瓣中,除2个皮瓣尖端局部坏死外,其余皮瓣均全部成活,修复后形态自然,效果满意。结论：结合儿童特点,在充分做好术前设计、提高手术技巧的前提下,皮肤软组织扩张术是修复儿童复杂瘢痕的理想选择。

Application of skin soft tissue expansion in complicated scars of children

Objective To summerize the experiences of skin soft tissue expansion in complicated scars of children. Methods 25 complicated scars of 22 children were reconstructed with expanded flaps, which including rotational,advanced, axial and island flaps, in two or three stages. Results 113 skin expanders were implanded. The biggest proportion repaired for one time was 20cm×18cm. 4 skin expanders were infected and exposed, 3 were leaked, and another 3 were overturned. Among the expanded flaps, all survived with satisfactory aesthetic and functional results but 2 flaps with little necrasis on edge. Conclusions Skin soft tissue expansion technique is plausible reconstructive option for complicted scars in children, but characteristics of children, good plans and meticulus prevention of complications shoule be kept in mind.