郭新雯　马娟　马少林

[摘要]目的：探讨皮肤软组织扩张术在整形修复治疗中的临床应用情况。方法：收集2011 年1 月～2014 年3 月，在我科利用皮肤软组织扩张术修复瘢痕或皮肤软组织缺损的病例58 例，其中头皮缺损17例，四肢瘢痕13例，颈前瘢痕7例，胸腹部瘢痕12，颌面部瘢痕9例。对患者的临床资料、术后修复情况以及病人自身治疗体会进行研究与总结。结果：本组58 例患者，共埋置71个扩张器，其中，扩张器外露2个，感染2个，血肿1个，并发症发生率为8.6%。经及时处理后正常扩张，扩张后皮瓣均满足修复区所需。术后随访6～18个月，扩张皮瓣平整、无明显回缩，皮肤色泽正常，外形良好，无功能障碍，疗效满意。结论：皮肤软组织扩张术在整形修复治疗中的应用效果较好，值得进一步在临床推广应用。

[关键词]皮肤软组织扩张术；整形；瘢痕；软组织缺损

[中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2014）20-1675-06

Application of skin and soft tissue expansion in plastic and reconstructive surgery

GUO Xin-wen1， MA Juan2，MA Shao-lin2

（1.Department of Plastic Surgery，Renai Hospital of Shanghai，Shanghai，200000，China；2.Department of the Plastic and Cosmetic Center，the First Affiliated Hospital，Xinjiang Medical University，Urumqi 830011，Xinjiang，China）

Abstract： Objective To explore the clinical application of skin and soft tissue expansion technique in plastic repair. Methods From January 2011 to March 2014， 58 cases of scar or skin and soft tissue defect were repaired by skin soft tissue expansion technique. We study and summary the clinical data of patients， postoperative restoration situation and the patient's own experience. Results Fifty eight cases with soft tissue expansion operation and followed up for 6 months to 18 months， the effect was satisfactory. 71 expanders were implanted， among them， the expansion capsule appeared in 2， infection in 2， hematoma in 1， the incidence of complications was 8.6%. Conclusion Skin and soft tissue expansion technique in the application of plastic repair treatment effect is good， is worth further clinical application.

Key words：skin and soft tissue expansion；plastic；scar；soft tissue defect

皮肤软组织扩张术是在正常皮肤软组织下置入皮下扩张器，通过增加扩张器内容量，使其表面皮肤软组织随之增殖和扩展，从而产生“额外”的皮肤，利用新增的皮肤软组织进行组织修复和器官再造。1976 年，Radovan首创将皮肤软组织扩张技术应用于一上肢纹身患者的临床治疗。1985年我国的张涤生教授等引进此技术至今将近30年，在临床上的应用已遍及全身各个部位，应用日益广泛，但对于该项技术的基础研究和技术改进仍在不断进行。我科自2011 年1月～2014 年3月利用皮肤软组织扩张术，对58例患者的瘢痕或皮肤软组织缺损进行修复治疗，疗效满意，现报道如下。……