治疗头皮病变的组织扩张器合适尺寸的回顾性分析。
A retrospective analysis on the proper size of tissue expanders to treat scalp lesions.
作者信息
Aya Rino, Kawai Katsuya, Kawazoe Takeshi, Suzuki Shigehiko
机构信息
Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.
出版信息
Plast Reconstr Surg Glob Open. 2014 Apr 7;2(3):e118. doi: 10.1097/GOX.0000000000000070. eCollection 2014 Mar.
BACKGROUND
Tissue expanders have become established instruments for scalp reconstruction. However, selection of the size of the expander has not been investigated systematically, and it generally depends on the experience of the surgeon.
METHODS
We retrospectively analyzed 21 patients who had undergone treatment for scalp lesions using tissue expanders without any complications and measured 2 variables: the volume of the expanders per area of the excised lesions and the hypothetical stretched functional skin width relative to the width of the excised lesions. We also sought to evaluate the relationship between these 2 variables and the need for revision surgery during the postoperative course.
RESULTS
The need for revision surgery was statistically higher in patients with a volume of 7 ml/cm(2) lesion or less and width of functional skin of less than 2.5 cm/cm lesion (P < 0.05). For scar repairs, the required size and volume of the expanders tended to be larger than those required for any other lesions.
CONCLUSIONS
Expanders that generate functional skin at least more than 2.5 times the width of the lesion and have a volume more than 7 ml/cm(2) lesion are necessary to cover scalp lesions without complications.
背景
组织扩张器已成为头皮重建的常用器械。然而，扩张器尺寸的选择尚未得到系统研究，通常取决于外科医生的经验。
方法
我们回顾性分析了21例使用组织扩张器治疗头皮病变且无任何并发症的患者，并测量了两个变量：每切除病变面积的扩张器体积以及相对于切除病变宽度的假设拉伸功能皮肤宽度。我们还试图评估这两个变量与术后病程中翻修手术需求之间的关系。
结果
对于每平方厘米病变体积为7毫升或更小且功能皮肤宽度小于每平方厘米病变2.5厘米的患者，翻修手术的需求在统计学上更高（P < 0.05）。对于瘢痕修复，扩张器所需的尺寸和体积往往比其他任何病变所需的更大。
结论
为了无并发症地覆盖头皮病变，需要使用能产生至少比病变宽度大2.5倍的功能皮肤且每平方厘米病变体积超过7毫升的扩张器。
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