Duclert-Bompaire M, Sallot A, Lardy H, Le Touze A
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 9, France.
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 9, France.
Ann Chir Plast Esthet. 2017 Apr;62(2):146-155. doi: 10.1016/j.anplas.2016.02.003. Epub 2016 Mar 19.
Tissue expansion is a plastic surgery technique which enables optimal quality and skin surface reconstruction in case of soft tissue defect. Despite the good results obtained, both from a functional and aesthetic point of view, there is a high rate of complications whose management seems to be essential to ensure satisfactory results.
We retrospectively reviewed the medical files of 45 children treated in our department between 2002 and 2012: 73 expanders were placed during 51 protocols.
The studied protocols gathered a large variety of situations. Varied pathologies were treated: burn sequelae (39 %), giant congenital naevus (GCN) (27 %), scars (20 %), hamartoms (8 %), cutis aplasia (6 %), as well as diverse sites: scalp (45 %), trunk (35 %), head and neck (8 %), lower extremity (8 %), upper extremity (4 %). Complications occurred in 17 protocols representing 26 % of total expanders. GCN is a pathology with a significantly lower complication rate (P=0.013) whereas trunk is an anatomical location with a significantly higher complication rate (P=0.026). Overall, 84 % of reconstructions were evaluated as having a good result. This rate reached 76 % for complicated protocols.
Tissue expansion in paediatric patients remains an efficient therapy in order to achieve a satisfactory reconstruction. Despite a high complication rate, good results can be obtained even in those complicated cases as long as they are well managed and anticipated. We also think that specific paediatric material would help to reduce supervention of some complications.
组织扩张术是一种整形手术技术，可在软组织缺损时实现最佳质量的皮肤表面重建。尽管从功能和美学角度都取得了良好效果，但并发症发生率较高，其处理对于确保满意结果似乎至关重要。
我们回顾性分析了2002年至2012年在我科接受治疗的45例儿童的病历：在51个治疗方案中放置了73个扩张器。
所研究的治疗方案涵盖了多种情况。治疗了多种病理情况：烧伤后遗症（39%）、巨大先天性痣（GCN）（27%）、瘢痕（20%）、错构瘤（8%）、皮肤发育不全（6%），以及不同部位：头皮（45%）、躯干（35%）、头颈部（8%）、下肢（8%）、上肢（4%）。17个治疗方案出现了并发症，占扩张器总数的26%。GCN是一种并发症发生率显著较低的病理情况（P = 0.013），而躯干是并发症发生率显著较高的解剖部位（P = 0.026）。总体而言，84%的重建评估为效果良好。复杂治疗方案的这一比例达到76%。
小儿患者的组织扩张术仍然是实现满意重建的有效治疗方法。尽管并发症发生率较高，但只要管理得当且有预期，即使在复杂病例中也能取得良好效果。我们还认为，特定的儿科材料将有助于减少某些并发症的发生。
