Burm Jin Sik, Hansen Juliana E
Oregon Health & Science University, Portland, USA.
Ann Plast Surg. 2010 Aug;65(2):193-6. doi: 10.1097/SAP.0b013e3181ba99f2.
Excising a keloid from the helical rim generally results in a narrow defect with exposed cartilage. Skin grafting is a surgical method with a lowest recurrence rate for keloid treatment. Full-thickness skin grafting may produce an excellent cosmetic outcome, but is generally considered too unreliable over a poorly vascularized defect with exposed cartilage. Adding a new healthy bed with rich vascularity on the periphery will increase the probability of the entire graft surviving via the bridging phenomenon. We report full-thickness skin grafting using a marginal deepithelialization technique for treatment of helical rim keloids. After keloid excision, the surrounding normal skin was deepithelialized 2 to 3 mm wide over the defect border, followed by full-thickness skin grafting. All grafts survived completely. None of the keloids recurred, and they all showed an excellent aesthetic result during the follow-up period from 9 months to 6 years.
从耳廓边缘切除瘢痕疙瘩通常会导致出现伴有软骨外露的狭窄缺损。皮肤移植是治疗瘢痕疙瘩复发率最低的手术方法。全厚皮片移植可能会产生极佳的美容效果，但在伴有软骨外露且血运不佳的缺损部位，全厚皮片移植通常被认为可靠性欠佳。在周边添加一个血运丰富的新健康创面，将通过桥接现象增加整个移植物存活的概率。我们报告采用边缘去上皮化技术进行全厚皮片移植治疗耳廓边缘瘢痕疙瘩。在切除瘢痕疙瘩后，在缺损边缘周围将正常皮肤去上皮化2至3毫米宽，随后进行全厚皮片移植。所有移植物均完全存活。在9个月至6年的随访期内，瘢痕疙瘩均未复发，且所有病例均呈现出极佳的美学效果。
