Yang Jui-Yung, Yang Shih-Yi
Linkou Burn Center, Department of Plastic Surgery, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan.
Ann Plast Surg. 2012 Dec;69(6):637-42. doi: 10.1097/SAP.0b013e318274d876.
Intrascar excision with debulking procedure is a good choice for scar revision in unique 3-dimensional facial aesthetic units, especially in the auricular area. It can remove or reduce scars in a shorter course without distortion of the surrounding anatomic structures and visible operative scars. This retrospective study was done to present intrascar excision procedures in persistent auricular hypertrophic scars or keloids.
Between 1997 and 2010, 18 ears in 13 patient cases with persistent hypertrophic scars and/or keloids in their external ear due to burns or trauma were collected for evaluation. There were 10 males and 3 females. The age distributions ranged from 5 to 49 years with an average of 20.1 years. All received intrascar excision with debulking procedure for their ear deformity. One case combined with YV-plasty procedure to obtain better aesthetic result. The follow-up period ranged from 0.3 to 14 years with an average of 3.6 years.
There was no recurrence in a series of average 3.6 years follow-up. Of the 13 patients, 11 (84.6%) objectively presented good and satisfactory surgical outcomes and the other 2 patients were acceptable.
The intrascar excision in auricular persistent scars or keloids has the following advantages: it (1) achieves primary closure, (2) does not distort the anatomic landmarks, (3) does not sacrifice the important structures, (4) has a debulking effect, (5) can be done anytime, even if scars are not mature, (6) has good cosmetic results, (7) may combine with Z- or VY-plasty for functional improvement, and (8) has minimal complications.
在独特的三维面部美学单元，尤其是耳部区域，采用减容手术的瘢痕内切除术是瘢痕修复的良好选择。它能在较短疗程内去除或减轻瘢痕，而不会使周围解剖结构变形或留下明显的手术瘢痕。本回顾性研究旨在介绍针对持续性耳部增生性瘢痕或瘢痕疙瘩的瘢痕内切除手术。
1997年至2010年期间，收集了13例因烧伤或创伤导致外耳持续性增生性瘢痕和/或瘢痕疙瘩患者的18只耳朵进行评估。其中男性10例，女性3例。年龄分布为5至49岁，平均20.1岁。所有患者均接受了瘢痕内切除联合减容手术以矫正耳部畸形。1例患者联合Y-V成形术以获得更好的美学效果。随访时间为0.3至14年，平均3.6年。
在平均3.6年的随访期内无一例复发。13例患者中，11例（84.6%）客观上呈现出良好且令人满意的手术效果，另外2例患者的效果也尚可接受。
耳部持续性瘢痕或瘢痕疙瘩的瘢痕内切除术具有以下优点：（1）实现一期缝合；（2）不使解剖标志变形；（3）不牺牲重要结构；（4）具有减容效果；（5）即使瘢痕未成熟也可随时进行手术；（6）美容效果良好；（7）可联合Z成形术或V-Y成形术改善功能；（8）并发症极少。
