大胆去做——光头又何妨？烧伤患儿头皮取皮术后数十年的结果。

Bold to do - bald to be? Outcomes decades after harvesting the scalp in burned children.

机构信息

Pediatric Burn Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8700 Zurich, Switzerland.

出版信息

Burns. 2019 May;45(3):543-553. doi: 10.1016/j.burns.2018.09.023. Epub 2018 Oct 15.

DOI:10.1016/j.burns.2018.09.023

PMID:30337156

Abstract

BACKGROUND

The scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp.

METHODS

Burn patients, hospitalized between 1977 and 1987 at the University Children's Hospital Zurich with scalp skin harvest and currently over 30years old, were studied. Medical records and patient satisfaction were analyzed, and a clinical scalp examination was performed.

RESULTS

Thirty-two patients (18 males, 14 females) with a current age of 34.13±3.42years participated. Mean follow-up time was 27.09±3.04years. Fifty-four scalp harvests were performed with 1.69±0.96 sequential harvests. Hair growth was considered normal in 97% patients. Androgenetic alopecia (AGA) type Norwood II-VI was seen in 11 patients. Scalp examination revealed 11 unknown likely harvest-related alopecias with a mean size of 0.7cm.

CONCLUSIONS

Long-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.

摘要

背景

头皮是唯一可用于获取断层皮片的隐匿供区。然而，由于担心医源性瘢痕性脱发，头皮往往未被充分利用。目前尚无长期数据表明雄激素性脱发是否会导致先前隐匿的瘢痕性脱发显现。我们旨在评估头皮取皮 30 年后的结果和患者满意度。

方法

对 1977 年至 1987 年期间在苏黎世大学儿童医院住院、接受头皮取皮且目前年龄超过 30 岁的烧伤患者进行研究。分析病历和患者满意度，并进行临床头皮检查。

结果

32 名患者（男 18 例，女 14 例），当前年龄为 34.13±3.42 岁。平均随访时间为 27.09±3.04 年。共进行 54 次头皮取皮，平均每例患者进行 1.69±0.96 次取皮。97%的患者认为头发生长正常。11 例患者出现雄激素性脱发（AGA）Ⅱ-Ⅵ 型。头皮检查发现 11 例未知的可能与取皮相关的脱发，平均大小为 0.7cm。