刘　毅　张鲜英等

刘毅张鲜英朱云肖斌

(兰州军区总医院烧伤整形科兰州730050)

［摘要］目的：介绍全颜面烧伤后瘢痕畸形的手术治疗经验。方法：全颜面瘢痕切除后，充分利用面部美学理论实施组织器官复位与畸形矫正，大张厚中厚皮片分区移植。结果：治疗此类患者9例，移植皮片均100%成活，受累器官畸形与缺损整复效果良好，容貌和功能恢复满意。结论：面部美学理论对于全颜面烧伤后瘢痕畸形的整复具有指导意义。

［关键词］颜面烧伤瘢痕整复

［中图分类号］R622［文献标识码］A［文章编号］1008-6455(2000)06-0430-03

AESTHETIC RECONSTRUCTING TECHNIQUE OF CICATRICIAL

DEFORMITIES OF WHOLE FACE AFTER BURN

LIU Yi,ZHANG Xianying,ZHU Yun,et al

Department of Burn and Plastic Surgery,Lanzhou General Hospital,

Lanzhou Command,PLA(Lan zhou730050)

［Abstract］Objective：To introduce the reconstructing experience of cicatricial deformities of whole face after burn.Methods：The aesthetic theory was employed to reconstruct deformities on face after cicatrics were excised,then thick split thickness skin grafts were transplanted according to different areas.Results：9 patients had been treated with this method .The survival rates of skin grafts were 100 percent in all patients.8 patients were followed up.The results showed that a good curative effect of appearance and function was achieved. Conclusion：The aesthetic theory has directive significance in reconstructing cicatricial deformities of whole face after burn.

［Key words］FaceBurnCicatrixReconstruction

颜面部是人体的特征部位，因其暴露而极易受到意外损伤，据文献报道火灾发生时面部烧伤的发生率为52%^〔1〕。全颜面深度烧伤晚期由于瘢痕增生与挛缩，常导致组织器官移位甚至缺损等毁容性畸形，并因功能障碍和外形丑陋，严重影响患者的正常工作与生活以至身心健康。我科自1995年以来，采用全颜面瘢痕切除，组织器官复位与畸形矫正，大张厚中厚皮片分区移植治疗全颜面烧伤后瘢痕畸形患者9例，取得了满意的疗效。

1临床资料

本组9例均为全颜面火焰深度烧伤晚期瘢痕，其中男性6例，女性3例。年龄9岁～28岁。畸形表现：全颜面不同程度的增生性瘢痕，同时伴睑外翻7例、内眦赘皮6例、鼻翼缺损7例、唇外翻5例、小口畸形4例等，严重毁容，外观丑陋，且受累器官功能不同程度受损。伤后至整复时间：7个月～12年。移植皮片面积：540cm2～660cm2。

2治疗方法

2.1麻醉手术在氯胺酮+局部浸润麻醉下进行。局部浸润麻醉采用肿胀法，即将0.25%普鲁卡因400ml+2%利多卡因20ml+盐酸肾上腺素2mg均匀注射于瘢痕下以减少术中出血和渗血。……