软组织扩张器一期修复电击伤颅骨外露并感染的临床研究

目的：比较软组织扩张器一期修复和分期修复两种术式治疗电击伤颅骨外露并感染的优缺点,以及一期修复的可行性。方法：1999年6月～2010年12月收治的电击伤合并头皮缺损颅骨外露并感染的患者共64例,创面面积180～480cm2。颅骨死骨凿除后,分别采用软组织扩张器行一期修复或分期修复,观察两种方式的修复效果。结果：两组患者扩张器埋置术后一期修复组扩张器外露发生率高于两期修复组;两组扩张囊内感染、皮瓣坏死的发生率比较无明显统计学差异。一期修复组愈后头部切口瘢痕秃发面积明显,并且患者住院时间短,花费较少。结论：一期修复术式在电击伤颅骨外露并感染时是可行的。治疗过程中早期积极预防扩张器外露。一期修复术式可减轻患者多次手术的痛苦和经济负担。

One-stage Repair of large area scalp defection and skull exposure and infection after electric burn by soft tissue expander

Objective：To investigate the advantages and disadvantages between one-stage repair and two-stages repair of large area scalp defection and skull exposure and infection after electric burn by soft tissue expander,and feasibility of one-stage repair.Methods：Admitted to 64 patients with large area scalp defection and skull exposure and infection after electric burn from June 1999 to Dec 2010,the wound area range 180cm2 to 480 cm2.After cutting the skull seauestrum,we treated it by One-stage Repair and two-stage repair operations.Results：The rate of postoperative complications of two kind of operation（expansion of the capsule infection,skin flap necrosis） showed no statistically significant difference exclude expander exposure.In the patients by the One-stage Repair,there is more obvious of the area of scar alopecia of incise,shorter hospitalization and less expensive;Conclusion：One-stage repair is feasible.It is vital to prevent expander exposure in the early time.This method can reduce the pain and economic burden of patient.