摘要目的 探讨导管外置式巨型扩张器修复复杂和大面积皮肤病损的临床效果.方法 选择247例皮肤病损患者和400～1000 ml扩张器.经皮肤小切口埋置扩张器,术后4d开始间断注水扩张.完成扩张后二期手术修复皮肤病损.患者接受扩张术1～4次.观察患者皮肤扩张成功率和并发症发生率.1年后随访手术效果.结果 247例共741个扩张部位,并发症122个,发生率为16.5％.其中8个扩张器因并发症未完成扩张终止治疗,扩张成功率为98.9％.完成扩张的病例注水扩张时间为64～113 d,平均92.7 d.扩张器超量注水量为扩张器额定容量的2.38倍.733个皮瓣中,成活729例,皮瓣成活率为98.4％.手术后1～5年随访116例276个扩张部位,手术切口瘢痕宽度0.3～1.2 mm.结论 用导管外置式巨型扩张器超量注水并重复扩张,是一种简单、安全、高效的皮肤病损修复方法.

abstractsObjective To study port-externalized tissue expansion technique and to provide a safe,simple and effective skin tissue expansion for extensive skin lesion reconstruction.Methods A lot of 247 patients with extensive skin lesion were chosen for the study.400-1000 ml tissue expanders were used for overexpansion and repeated expansion.Expanders were inserted into subcutaneous pockets through mini-invasive incisions and intermittent injection was carried out 4 days after first stage operation.After expansion finished,expanded skin flaps were transplanted for skin lesion reconstruction.During inflation period,complications and expander failures were observed.Results In 741 expanders of 247 patients,complication rate was 16.5 ％ with total 122 cases of complications.Expansion success rate was 98.9 ％ with 8 expander failures.Expanders were inflated successfully between 64-113 days,with average 92.7 days.The inflated saline volume was 2.38 times of marked expander capacity.In this group of 733 expanded skin flaps,721 flaps were well survived with 98.4％ success rate.276 expanded flaps of 116 patients were followed up for one to five years post-operation.The width of incision scar was between 0.3-1.2 mm.Conclusions The port-externalized overexpansion with giant expanders is a safe,simple and feasible technique,which is worthy of further clinical application.