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使用预扩张头皮瓣修复面部缺损:所采用方法及43例患者的治疗结果描述

Reconstruction of facial defects using a pre-expanded scalp flap: A description of the method used and outcomes of 43 patients.

作者信息

Ding Jianke, Chu Feifei, Tang Yinke, Liu Shiqiang, Zeng Xianhui, Yang Qing, Ma Xianjie

机构信息

Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

Department of Burn and Plastic Surgery, PLA No. 983 Hospital, Tianjin, China.

出版信息

Front Surg. 2022 Aug 8;9:962737. doi: 10.3389/fsurg.2022.962737. eCollection 2022.

Abstract

BACKGROUND

A technique for reconstructing facial units with matching colour, similar texture and sufficient contour is ideal for patients with various facial defects. The current report aimed to present the experience of the authors in facial reconstruction using pre-expanded scalp flaps combined with laser hair removal.

METHODS

From January 2014 to August 2021, 43 patients with different facial defects, such as post-burn scar and congenital nevus, were treated using this surgical technique that involved tissue expansion, scalp flap transfer and laser hair removal. Facial defects were artificially classified into three regions (forehead,  = 19; cheek,  = 15; and lips and chin,  = 9). Pedicle delaying and division were performed in patients who underwent reconstruction with pedicled flaps.

RESULTS

Of the included patients, one presented with haematoma, one with infection and three had distal necrosis after expanded scalp flap transfer. The donor site was primarily closed in all patients. Further, all patients were successfully treated without major complications. The texture, colour and contour of the scalp flap after laser hair removal matched well with the surrounding skin tissues at 2-30-month follow-up.

CONCLUSION

Reconstruction using pre-expanded scalp flaps combined with laser hair removal is an effective and reliable option for facial reconstruction with excellent colour and texture match.

摘要

背景

对于各种面部缺损患者而言,采用颜色匹配、质地相似且轮廓足够的技术来重建面部单元是理想之选。本报告旨在介绍作者使用预扩张头皮瓣联合激光脱毛进行面部重建的经验。

方法

2014年1月至2021年8月,43例不同面部缺损患者,如烧伤后瘢痕和先天性痣患者,采用了这种包括组织扩张、头皮瓣转移和激光脱毛的手术技术进行治疗。面部缺损人为分为三个区域(前额,19例;脸颊,15例;嘴唇和下巴,9例)。接受带蒂皮瓣重建的患者进行了蒂延迟和切断。

结果

纳入患者中,1例出现血肿,1例发生感染,3例在扩张头皮瓣转移后出现远端坏死。所有患者的供区均一期缝合。此外,所有患者均成功治疗,无重大并发症。在2至30个月的随访中,激光脱毛后头皮瓣的质地、颜色和轮廓与周围皮肤组织匹配良好。

结论

使用预扩张头皮瓣联合激光脱毛进行重建是面部重建的一种有效且可靠的选择,颜色和质地匹配良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50ea/9393413/80d457a7b707/fsurg-09-962737-g001.jpg

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