Marck K W, de Bruijn H P
Sokoto Specialist Hospital, Nigeria.
Oral Dis. 1999 Apr;5(2):167-71. doi: 10.1111/j.1601-0825.1999.tb00084.x.
In the acute stage of noma the role of surgery is a minor one: wound care and, very occasionally, treatment of haemorrhage. However in patients who survive noma, and develop a mutilated and disabled face (trismus, leakage of saliva, impaired speech), reconstructive surgery may improve their fate significantly. Because of economic and educational reasons reconstructive surgery in noma patients should be performed preferably in their own country. Treatment consists of excision of all scar tissue, correction of the trismus and closure of the tissue defects with local, pedicled or free flaps. Because of the large variety of tissue defects and the many surgical options, systematization and subsequently standardization of the reconstructive surgical approach to patients with the sequelae of noma is needed.
在走马疳急性期，手术的作用较小：主要是伤口护理，偶尔进行出血处理。然而，对于走马疳幸存者且面部出现毁损和功能障碍（牙关紧闭、唾液渗漏、言语受损）的患者，重建手术可能会显著改善其预后。出于经济和教育方面的原因，走马疳患者的重建手术最好在其本国进行。治疗包括切除所有瘢痕组织、矫正牙关紧闭，并采用局部皮瓣、带蒂皮瓣或游离皮瓣修复组织缺损。由于组织缺损种类繁多且手术选择多样，因此需要对走马疳后遗症患者的重建手术方法进行系统化并随后标准化。
