摘要目的 探讨皮肤软组织扩张术在颈部瘢痕中应用的临床效果.方法 2009年3月至2018年5月新疆克拉玛依市中心医院烧伤整形科收治15例颈部烧伤后瘢痕患者,男12例,女3例,年龄12～48岁,平均31岁,瘢痕面积9 cm×6 cm～14 cm×11 cm.一期手术在颈部瘢痕一侧或两侧附近正常皮肤区域皮下埋置100～300 ml的皮肤软组织扩张器.术后10～ 14 d注入生理盐水进行扩张,每次间隔10d,扩张3～9个月.扩张后静置1个月左右,行二期手术,取出扩张器,切除颈部瘢痕,将扩张皮瓣转移修复缺损创面.结果 15例中2例扩张后期因摩擦出现扩张器轻度外露,予以碘伏纱布包扎,未影响最终治疗效果;其余13例扩张皮瓣血运良好.扩张皮瓣大小为12 cm×8 cm ～16 cm× 15 cm,二期术后皮瓣全部成活.术后随访0.5～5年,皮瓣色泽、质地与邻近正常皮肤相近,临床修复效果满意.结论 皮肤软组织扩张术修复颈部瘢痕,安全可靠,效果显著.

abstractsObjective To investigate the clinical outcomes of skin and soft tissue expansion in the repairment of neck scar.Methods From March 2009 to May 2018,15 patients with postburn scar contractures on neck,were admitted to the Department of Burn and Plastic Surgery,Karamay Central Hospital of Xinjiang.The patients include 12 males and 3 females,aged 12 to 48 years,with the mean age of 31 years.The scars were at 9 cm×6 cm-14 cm×11 cm in size.The tissue expander of 100-300 ml was placed subcutaneously,in the normal skin area on neck,on one or each side at the first stage operation.The first expander infusion was performed 10-14 days after surgery.The tissue expansion remains for 3-9 months,with an interval of 10 days of each infusion.After the tissue fully expanded,the expander was maintained for 1 month.At the second stage,the expander was removed,and the expanded flap was transferred to repair the wound.Results The expander exposure due to friction occurred in 2 patients.The final therapeutic effect was not affected,because of iodine gauze bandage.Blood supply of expanded flaps was good in other patients.The size of the expanded flaps was 12 cm×8 cm-16 cm× 15 cm.All flaps survived after the second stage surgery.Patients were followed up for 0.5-5 years after surgery.The color and texture of flaps was similar to adjacent normal skin.Conclusions Skin and soft tissue expansion is a safe and effective method in repairing neck scar.