Neale H W, High R M, Billmire D A, Carey J P, Smith D, Warden G
University of Cincinnati, College of Medicine, Division of Plastic Surgery, Ohio 45267.
Plast Reconstr Surg. 1988 Nov;82(5):840-8. doi: 10.1097/00006534-198811000-00018.
All patients at the Burn Institute reconstructed with tissue expanders between June of 1984 and June of 1987 were included in this review. There were 122 expanders used in 77 patients. Complications were defined as "absolute" (23 of 122 expanders, 20 percent) if they resulted in loss of expanders or additional surgery or none of preoperative plan was satisfied or "relative" (14 of 122 expanders, 11 percent) if they included spotty alopecia or alopecia greater than 50 percent or the operative plan only partially satisfied, reflecting poor judgment. The most common absolute complication was prosthetic exposure secondary to wound dehiscence occurring in the scalp area. Complications relative to specific anatomic areas were neck and face, 2 of 20 (10 percent); lower extremity, 1 of 4 (25 percent); trunk, 0 of 6 (0 percent); and scalp, 20 of 92 (22 percent). We feel that this high complication rate in the use of tissue expanders may be unique to the pediatric burn patient. Knowledge of indications for use and potential complications is essential to add this entity to the armamentarium of the burn reconstructive surgeon.
本回顾性研究纳入了1984年6月至1987年6月期间在烧伤研究所接受组织扩张器重建的所有患者。77例患者共使用了122个扩张器。并发症被定义为“绝对”（122个扩张器中有23个，占20%），即导致扩张器丢失、需要额外手术或未满足任何术前计划；或“相对”（122个扩张器中有14个，占11%），即包括散在性脱发或脱发超过50%，或手术计划仅部分得到满足，反映判断不佳。最常见的绝对并发症是头皮区域伤口裂开继发的假体暴露。特定解剖区域的相对并发症为：颈部和面部，20例中有2例（10%）；下肢，4例中有1例（25%）；躯干，6例中0例（0%）；头皮，92例中有20例（22%）。我们认为，组织扩张器使用中的这种高并发症发生率可能是小儿烧伤患者所特有的。了解其使用指征和潜在并发症对于烧伤重建外科医生将这一方法纳入其技术储备至关重要。
