黄金华

【摘 要】目的：探讨颈部瘢痕挛缩畸形整形手术方法及其效果。方法：颈部痕挛缩畸形II度行“Z"'成形术。全厚皮片移植2例：颈部瘢痕挛缩畸形Ⅲ度行瘢痕松解切除全厚皮片移植加局部旋转带蒂皮瓣修复颈前创面1例。效果：3例病人均恢复颌颈角，颈部伸曲自如，外观满意。结论：根据颈部瘢痕挛缩的面积及程度，选择手术方法，力争一张皮片覆盖创面，无逢接，达到术后美观，转移皮片可达：2. 5*4. 5cm?，一次修剪皮下组织，保证血供，达到恢复颈部运动功能及外观完美效果。

【关键词】颈部瘢痕挛缩畸形；“Z”成形术；全厚皮片无逢接局部旋转皮瓣移植

[Abstract] Objective：The constructive surgery is to investigate the methods and effects， which will treat atrophic and cicatrical scar on the neck. Methods：The deformities of atrophic and cicatrical scar on the neck formed as a letter "Z". 2 cases of the total thick skin were transplanted.The deformities of atrophic and cicatrical scar were excised.l case about the scar on the front part of neck，which was Tranplanted and local revolving replaced part of skin on the neck. Result： 3 cases was satisfied with this treat . The neck streched casily . The appearances of the neck looked normal. Conclusion：Choosing surgery based on the area and level of the scar on the neck. Striving for the total skin covered the scar without crack， then the surgery will be perfect. Subcutaneous tissue were repaired in one stage for providing blood transporting. This operation transplanted skin about 2. 5*4 .5 cm?， which is a perfect treatment.

[Key words] The deformities of atrophic and cicatrical scar on the neck formed as a letter"Z"， which was transplanted with total thick skin.

【中图分类号】R622 【文献标识码】B 【文章编号】2095-6851（2018）05--01

2016年以来我院收治3例颈部瘢痕挛缩畸形病人，两例为II度一例为III度，因影响颈部运动功能及影响外貌，患者迫切要求手术改善现状。我们根据瘢痕挛缩程度及切除范围大小选择不同手术方法，取得满意效果。现报告如下：

1 临床资料

1.1 一般资料 3例患者，男2例女1例，年龄分别为19岁、22岁、26岁。两例为化学药物硫酸烧伤所致，一例为汽油烧伤所致。两例为颈前条索状瘢痕挛缩加环形增生瘢痕，一例为颏下颈前瘢痕挛缩畸形。采用“Z"成形术一次性切除瘢痕，松解后全厚皮片覆盖两例；瘢痕切除松解粘连后全厚皮片游离植皮，颈前局部转移皮瓣修复创面一例。

1.2 结果 例病人术后均恢复颈部功能，颌颈角明显，男病人喉结突出，近日随诊，病人功能与外观均良好，效果满意。

2 手术方法

2.1 麻醉：三例手术均为经口插管全麻。……