Dogra Bharat B, Sharma Alok, Singh Manmohan, Chakravarty Bijitesh
Department of Plastic Surgery, Armed Forces Medical College, Pune, India.
Int Surg. 2007 Jan-Feb;92(1):37-45.
Post-traumatic soft tissue loss results in significant functional and esthetic morbidity. Reconstruction is often limited by shortage of soft tissues. Esthetic and functional restorations are possible by generation of well-matched autogenous sensate tissue by tissue expansion. Fifteen (nine females and six males) cases of large and complex soft tissue defects after trauma, age ranging from 7 to 43 years of age, were managed by tissue expansion over a period of 22 months. Indications were post-burn scars of the face (five), post-burn alopecia (three), avulsion injury scalp (one), massive abdominal wall defect (one), post-crush injury ankylosis of the right elbow (one), and post-burn contracture of the neck (three). Tissue expansion was well tolerated by all patients. Major complications seen were accidental implant deflation (6.6%) and partial implant exposure (6.6%). Minor complications were seen in 20% of the cases. Tissue expansion is slow and staged but a simple and safe reconstructive technique for managing large post-traumatic soft tissue loss with excellent results.
创伤后软组织缺损会导致严重的功能和美观问题。重建往往因软组织短缺而受到限制。通过组织扩张生成匹配良好的自体感觉组织,可以实现美观和功能的恢复。15例(9例女性和6例男性)创伤后大面积复杂软组织缺损患者,年龄在7至43岁之间,在22个月的时间里通过组织扩张进行治疗。适应症包括面部烧伤后瘢痕(5例)、烧伤后脱发(3例)、头皮撕脱伤(1例)、巨大腹壁缺损(1例)、挤压伤后右肘强直(1例)以及烧伤后颈部挛缩(3例)。所有患者对组织扩张的耐受性良好。主要并发症为意外植入物放气(6.6%)和部分植入物外露(6.6%)。20%的病例出现轻微并发症。组织扩张过程缓慢且分阶段进行,但对于处理创伤后大面积软组织缺损而言,是一种简单且安全的重建技术,效果极佳。