烧伤后面部挛缩和畸形的重建
Reconstruction of Postburn Contracture and Deformity

面部是最具特征性的暴露部位，面部的眼、耳、鼻及口等器官和谐地构成人体的容貌，遭受烧伤损害，轻者留下瘢痕，重者造成毁容，严重影响患者的面部形态及功能，并给患者带来巨大的精神和心理影响，面部烧伤挛缩的重建是整形和重建手术中最重要的手术之一，这项研究旨在评估面部重建所使用的不同方式及其结果。回顾性研究我院涉及12例广泛燃烧的面部疤痕患者，包括病因，人口统计学数据，紧急处理和结果。用不同的重建方式(如裂开/全厚的皮肤移植物或皮瓣等)对患者进行治疗。根据涉及的面部面积，移植物的摄取情况和并发症，对不同方式的结果进行分析，大多数患者的年龄在20~40岁之间。74.21%的患者还有其他与面部受累相关的烧伤。大多数患者90%在烧伤持续9个月后得到治疗。所有患者的面部多区域受累，但主要是脸颊，全层皮肤移植Full thickness skin graft (FTSG)和分层皮肤移植split thickness skin grafts (STSG)是最常用的程序。前额疤痕患者接受分阶段的腹部皮瓣转移治疗。两名眼睑外翻患者采用STSG治疗。组织扩张器不可用，脸颊上的线状疤痕可以切除和一期z成形术。切除耳朵的肥厚性瘢痕并应用STSG。常见的并发症包括色素沉着过多和色素沉着不足，轮廓变形和唇沟闭塞，烧伤疤痕的面部重建程序应根据所涉及的面部区域进行选择。植皮是一种有效的重建方法，尤其是在无法使用高级治疗基层医院。
Reconstruction of facial burn contracture is one of the most important procedures in plastic and reconstructive surgery. This study aimed to evaluate the different ways used for facial reconstruction and its results. Retrospective study of our hospital involved 12 patients with extensive burning facial scar. Patients were treated with different reconstruction modalities such as split/full- thick skin grafts or flaps. According to the facial area involved, graft uptake and complications, the results of different ways were analyzed. Most patients were between 20 - 40 years old. 74.21% of patients had other burns associated with facial involvement. Most patients 90% were treated after the burn lasted 9 months. All patients had multiple facial lesions, but mostly cheeks. Full thickness skin graft (FTSG) and split thickness skin grafts (STSG) are the most commonly used procedures. Patients with frontal scar receive a phased abdominal flap transfer. Two patients with eyelid valgus were treated with STSG. Tissue dilators are not available, linear scars on cheeks can be removed and primary z surgery. The hypertrophic scar of the ear is removed and STSG is applied. Common complications include hyperpigmentation and insufficient pigmentation, contour deformation and lip sulcus occlusion, and facial reconstruction procedures for burn scars should be selected according to the facial area involved. Skin grafting is an effective method of reconstruction, especially in hospitals where advanced treatment is not available.