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组织扩张术:一种用于复杂创伤性软组织缺损的简易技术。

Tissue expansion: A simple technique for complex traumatic soft tissue defects.

作者信息

Dogra Bharat B, Sharma Alok, Singh Manmohan, Chakravarty Bijitesh

机构信息

Department of Plastic Surgery, Armed Forces Medical College, Pune, India.

出版信息

Int Surg. 2007 Jan-Feb;92(1):37-45.

Abstract

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.

摘要

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。

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