[摘要]目的：探讨运用整形美容技术急诊修复严重颌面部外伤的技巧与临床效果。方法：回顾性分析2020年6月-2024年2月笔者科室采用整形美容外科技术治疗的64例符合入选标准的严重颌面部外伤患者的临床资料，所有患者外伤均累及颌面部多个解剖单元，并存在不同程度的肌肉、骨等深部组织损伤与贯通伤。所有患者均急诊接受整形美容修复，并于术后3～12个月随访，术后6个月采用瘢痕美容评估与评级量表（SCAR）评价瘢痕情况，并调查患者满意度。结果：所有患者中，2例犬咬伤患者于术后3 d感染，局部红肿、积脓，予以拆除缝线，双氧水冲洗，脓肿引流换药，炎症控制后，再次缝合，余创面均一期愈合。术后6月SCAR评分为（1.9±0.5）分，患者满意度评分（7.8±0.4）分。结论：整形美容技术能显著改善严重颌面部外伤的急症修复效果，减轻瘢痕增生，提高患者满意度。

[关键词]颌面部；创伤；整形美容技术；瘢痕；满意度；急诊修复

[中图分类号]R622" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0028-04

Application of Plastic Cosmetic Techniques in Emergenry Repair of Severe Maxillofacial Trauma

TAO Junsheng1， SUN Jianshuai1， CHEN Liming2， LI Jinhui1， MAI Faxuan1， LU Ting1， LIU Yi1，2

（ 1.Department of Burns Plastic and Wound Repair Surgery， Liangzhou Hospital of Wuwei， Wuwei 733399， Gansu， China; 2.Department of Burns Plastic and Wound Repair Surgery， the Second Hospital of Lanzhou University， Lanzhou 730050， Gansu， China ）

Abstract： Objective" To study repair techniques and clinical effect of plastic surgery technology in emergency repair of severe maxillofacial trauma. Methods" The clinical data of 64 patients with severe maxillofacial trauma who met the inclusion criteria and were treated with plastic and aesthetic surgery techniques in the author's department from June 2020 to February 2024 were retrospectively analyzed. All patients' trauma involved multiple maxillofacial anatomical units， and there were different degrees of deep tissue injury and penetrating injury such as muscle and bone. All patients received emergency plastic and cosmetic repair， and were followed up for 3 to 12 months after operation. SCAR cosmetic assessment and Rating scale （SCAR） was used to evaluate the scar 6 months after operation， and patient satisfaction was investigated. Results" Of all cases， 2 cases inguried by dog bite were infected 3 days after surgery， with local redness and pus accumulation. Sutures were removed， hydrogen peroxide irrigation， abscess drainage and dressing change. After inflammation control， they were sutured again， and the remaining wounds were healed once. The postoperative June SCAR score was （1.9±0.5） and the patient satisfaction score （7.8±0.4）. Conclusion" Plastic surgery technology could effectively improve emergency repair effect of severe maxillofacial trauma， reduce scar hyperplasia and improve patient satisfaction.

Key words： maxillofacial; trauma; plastic surgery technology; scar; patient satisfaction; emergency repair

颌面部严重外伤的致伤因素较多，主要包括道路交通事故伤、机械性创伤及动物咬伤等[1-2]。临床观察发现，急诊处理中采用简单缝合技术易引发显著的瘢痕增生反应，且可能伴随局部组织形态异常[3]。尽管术后综合干预方案（如糖皮质激素局部注射、压力疗法及光电治疗等）可有效抑制瘢痕形成，但损伤初期的清创质量与缝合技术对创面愈合具有决定性影响[4-5]。笔者回顾性分析了2020年6月-2024年2月笔者科室采用整形美容技术急诊修复的64例严重颌面部外伤患者的临床资料，旨在探讨整形美容技术在严重颌面部外伤急诊修复中的技巧与应用效果，具体如下。……