Li Peng-cheng, Hu Guo-dong, Jia Chi-yu, Qiu Ya-bin, Wu Yu-jia, Zheng Shu-juan
Plastic Surgery and Burn Repair Center, the 309th Hospital of PLA, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2013 Apr 9;93(14):1055-7.
To contrive an effective method of repairing the scar in bilateral faciocervical region.
Between April 2009 and February 2012, 9 patients with large scars on face and neck due to burn and scald were treated. There were 5 cases with face scars and 4 cervical scars. Their average age was 33 years (range: 23-48 years). The disease duration was 6 months to 20 years (mean: 6.5 years). The scar area was 12 cm × 7 cm to 22 cm × 26 cm. The soft tissue expanders (600-800 ml in volume) were implanted in delto-pectoral zone in one-stage operation. In two-stage operation, after the resection of cervical scars, the defects were repaired with delto-pectoral perforator flaps. In 5 facial scar cases, skin flap pedicle division was performed at Week 3. After the resection of scars, all wounds were repaired by expansion flap. The donor sites were sutured directly. The area of removed scar and the status of flap blood supply were observed. And the texture of flaps and patient satisfaction score were followed up for 6-30 months.
Mild congestion of flap occurred postoperatively 1 case. The other flaps survived successfully. The flaps of 2 cases appeared bulky after transposition and flap repair was performed at Month 6. The appearance, texture, and color of flaps were similar to those at the donor sites. And there was an excellent match of flaps and recipient place.The patient satisfaction score was 7.6 ± 2.3. All achieved satisfactory functional and aesthetic outcomes.
The method has many advantages and its clinical application is both safe and effective.
设计一种修复双侧面颈部瘢痕的有效方法。
2009年4月至2012年2月，对9例因烧伤和烫伤导致面颈部大面积瘢痕的患者进行治疗。其中面部瘢痕5例，颈部瘢痕4例。平均年龄33岁（范围：23 - 48岁）。病程6个月至20年（平均：6.5年）。瘢痕面积为12 cm×7 cm至22 cm×26 cm。一期手术在三角胸肌区植入体积为600 - 800 ml的软组织扩张器。二期手术，切除颈部瘢痕后，用三角胸肌穿支皮瓣修复缺损。5例面部瘢痕患者在第3周进行皮瓣断蒂。切除瘢痕后，所有创面均用扩张皮瓣修复。供区直接缝合。观察切除瘢痕的面积及皮瓣血供情况。并对皮瓣质地及患者满意度评分进行6 - 30个月的随访。
术后1例皮瓣出现轻度充血，其他皮瓣均顺利成活。2例皮瓣转移后显得臃肿，于第6个月进行了皮瓣修整。皮瓣的外观、质地和颜色与供区相似。皮瓣与受区匹配良好。患者满意度评分为7.6±2.3。均取得了满意的功能和美学效果。
该方法具有诸多优点，临床应用安全有效。
