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-  2017 

以颞浅血管顶支为蒂的扩张头皮岛状瓣再造鬓角的临床研究

DOI: doi:10.7507/1002-1892.201706019

Keywords: 鬓角再造, 扩张皮瓣, 颞浅血管, 头皮岛状瓣, 顶支

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Abstract:

目的 探讨应用以颞浅血管顶支为蒂的头皮岛状瓣再造鬓角的可行性和临床疗效。 方法 2012 年 2 月—2015 年 4 月,收治 7 例拟再造鬓角患者。男 3 例,女 4 例;年龄 4~44 岁,平均 15 岁。烧烫伤后瘢痕 3 例,外伤瘢痕 1 例,血管瘤同位素放射治疗后瘢痕 1 例,先天性色素痣 2 例。鬓角缺损范围为 5.0 cm×3.5 cm~16.0 cm×10.0 cm。一期根据鬓角区皮肤软组织缺损大小,在包含颞浅血管顶支的正常头皮组织下埋置皮肤软组织扩张器,术后定期注水扩张;一期术后 3~6 个月,待扩张头皮达到预期修复所需组织量时,二期手术取出扩张器,切取以颞浅血管顶支为蒂的头皮岛状瓣修复鬓角软组织缺损,皮瓣范围为 8 cm×3 cm~17 cm×11 cm。供区直接拉拢缝合。 结果 术后皮瓣均顺利成活,受区创面及供区切口均 Ⅰ 期愈合。患者均获随访,随访时间 1~36 个月,平均 9.8 个月。再造鬓角形态、毛发密度、毛发生长方向与对侧正常鬓角相似。1 例术后皮瓣毛发超出原有发际线,经激光脱毛处理外观满意。 结论 应用以颞浅血管顶支为蒂的扩张头皮岛状瓣修复鬓角区皮肤软组织缺损,再造鬓角外观与对侧正常鬓角相似,是一种有效修复方法

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