【作者】 王美水；

【导师】 庄福连； 许东坡；

【作者基本信息】 福建医科大学 ， 外科学， 2003， 硕士

【摘要】 目的 探讨一种简单易行的持续快速皮肤软组织扩张方法及其临床应用。 方法 分两期手术：Ⅰ期手术在病变内设计垂直小切口埋植扩张器，术后第二天开始用微量推注泵作持续注水扩张，主要根据病人的痛觉反应和皮肤血运情况调整注水速度，完成预计注水量。注水结束后3～5天行Ⅱ期手术整复治疗，观察手术效果。 结果 临床应用22例，其中瘢痕16例、毛细血管瘤2例、色素痣2例，鼻缺损2例，共埋置扩张器35个，平均注水扩张时间15.3天，扩张过程中1例出现切口处扩张器外露，其余21例扩张过程顺利。Ⅱ期术后出现1例扩张皮瓣远端发生静脉回流障碍致部分坏死，其余21例术后转移皮瓣成活均良好。经3个月～1年的随访，效果满意。 结论 采用病变内垂直小切口埋入扩张器，并早期应用微量推注泵作持续注水扩张可以最大限度地缩短扩张期时间和患者住院时间，简单易行，安全可靠，是一种较理想的快速扩张术式，值得推广应用。更多还原

【Abstract】 Objective: To study a simple surgical method for continuous rapid tissue expansion and its clinical application.Methods: The operation can be accomplished in two-stage procedures. First, expanders were placed in the subcutaneous pocket through interlesional perpendicular short incisions. Continuous expansion by trace syringe pump began from the second day after expander placement. The speed of water injection was set by according to patient’s algesthesia reaction and vascularity of skin. The second operation was carried out at the third to fifth day after the expansion completed. Results to continuous expansion were assessed.Result: The method was put into clinical practice on 22 cases (16 cases of scar,2 cases of capillary angioma, 2 cases of black nevus, 2 cases of nasal defect), and35 expanders were placed. The mean time of water injection was 15.3 days. In the process of expansion, all cases were satisfactory except 1 case, in which the expander exposed in the incision. After the second operation, all flaps survived except 1 flap showing distal skin necrosis. The result was satisfactory after 3 months to 1 year follow-up visits.Conclusion: The clinical procedure which consists of expander placement through interlesional perpendicular short incisions and continuous expansion in advance, maximally shortened the time of expansion and hospitalization. This expansion method was a simple, safe, reliable, and ideal rapid tissue expansion. It is worth of wide application.更多还原