摘要目的 探讨皮肤扩张术在治疗面部先天性巨型黑色素细胞痣(巨痣)的应用效果.方法 应用面部扩张皮瓣修复面部先天性巨痣患者7例,包括单次扩张和重复扩张.利用部分切除加软组织扩张术的方法分期完全切除患者面部的巨痣.手术遵循合理设计、注意无瘤操作和无张力原则;多个扩张器使用时一定要将扩张器彼此贯通,减少包膜形成,有利二期手术皮瓣转移.结果 7例病灶均位于面部,巨痣均完全切除,面积7 cm×5 cm至15 cm×13 cm.术后随访3～12个月(平均6个月),所有皮瓣均成活良好.2例后期扩张器外露,未影响皮瓣转移;1例因切口瘢痕行二期修整,效果满意.结论 面部皮肤扩张术是面部先天性巨痣较为理想的治疗方法.

abstractsObjective To investigate the effect of tissue expansion in facial congenital giant nevus.Methods From October 2014 to October 2016,7 cases of facial congenital giant nevus patients were treated with expanded skin flaps,including single expansion and secondary expansion.Partial excision and skin tissue expansion were used to drastically remove giant pigmented nevi on body or extremities of infants.There were some points for attention during the surgery:the size and location of the partial excision and expander should be designed reasonably;no tumor-manipulation and non-tension principle should be taken great notice,and expanders should be linked up with one another when several expanders were used at the same time,so as to reduce the possibility of forming the envelop,which was favorable for the second surgery of transfer of a skin flap.Results All cases of giant pigmented nevi excision were on the face,which were completely removed from the patients.The areas of the nevi were from 7 cm × 5 cm to 15 cm × 13 cm.All patients were followed up for 3-12 months (mean 6 months).All flaps survived well.Expander exposure was happened in 2 cases with no bad results.One case of scar received late repair due to surgical scars and all got satisfactory results.Conclusions Tissue expansion is an ideal method in the treatment of facial congenital giant nevus.