下肢象皮肿的外科治疗(附2O例报告)

1991年2月至1997年2月对20例22条下肢象皮肿施行了病变组织切除,原位全层皮片游离移植术,其中6条肢体合并施行大腿部分病变组织切除真皮埋入术。经2～6年随访,22条肢体臃肿消失,19条肢体丹毒未再发作,皮肤逐渐变软,活动正常。3条肢体足背有少量淋巴液渗出,丹毒仍有发作,但比术前次数减少。予防复发的关键是切除病变要彻底,原位全层皮片游离移植为佳,术后要长期应用弹力绷带包扎或穿弹力袜,避免站立工作。

Surgical Treatment for Elephantiasis of Lower Extremity

From February 1991 to February 1997 the extensive resection of pathological lession over the involved area and full thickness free graft in situ were performed to treat 20 patients with elephantiasis crus(22 legs). Among them partial excision of pathological lession and implanted dermis graft were performed in 6 cases. The patients have been followed for 2 to 6 years after operation. Cumb.ersome legs diss-appered in all of cases. Erysipelas no longer occurred in 19 limbs. The skin was progressively softened. The patients have full motion of their leg. A small number of lymphatic effusion in the dorsum of foot may be found, and erysipelas still occurred occationally,but attacks reduced in 3 legs. The keys to prevent against recurrence of eplephantiasis involvded thorough resection of pathological lession,full thickness free graft in situ ,long term use of elastic bandage or elastic stockings guard, and avoidance of a standing work.