皮肤扩张期间的激光脱毛治疗(1)
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[摘要]目的:探讨皮肤扩张期间的激光脱毛治疗。方法:应用Coolide V型Nd:YAG激光系统对扩张皮肤进行脱毛治疗,激光波长1 064nm,光斑大小为10mm,能量35～45J/cm2。遵循由低到高的原则进行激光能量调节,脱毛前后冰敷以及激光冷却探头与皮肤充分接触以减少扩张皮肤血管损伤。结果:应用本方法进行耳部扩张皮肤脱毛和额部扩张皮肤脱毛各5例,脱毛效果良好,扩张皮瓣转移进行耳再造和鼻再造手术效果满意,未见扩张皮肤并发症发生。结论:皮肤扩张期间的脱毛治疗是安全可靠的,适当的激光能量调节和脱毛操作有利于避免和减少激光对扩张皮肤的损伤,安全顺利完成皮瓣转移手术。
[关键词]皮肤扩张术;激光脱毛;耳再造;鼻再造
[中图分类号]R616.4[文献标识码]A[文章编号]1008-6455(2010)10-1513-02
Laser depilation on expension skin
LI De-yan, LIU Yu-sheng, CHEN Ke-qiong,GAO Yan
(Department of Medical Cosmetology,Dongguan people's Hospital,Dongguan 523018,Guangdong,China)
Abstracts: Objective To investigate laser depilation on expension skin. Methods Coolide V Nd:YAG laser system was used on expension skin for hair removing. Laser wavelength 1 064 nm, facula 10mm, laser dosage 35~45J/cm2. The depilation was started from low laser dose and gradually increased to an ideal dose. It is very important for deminishing skin damage of the ice apply and the probe contact with the skin during laser depilation. Results Laser depilation were applied on 10 cases of auricular and forehead expension skin with all ideal results. All auriclar reconstruction and nasal reconstruction with the depilated expension skin were good. There were no complications observed during depilation and reconstruction procedures.ConclusionLaser depilation is safe during skin expension. Approprate laser dose and epilation manipulation are important for deminishing the skin damage and safe reconsturction.
Key words: skin expension; laser depilation; auricular reconstruction;nasal reconstruction
皮肤软组织扩张术是整形外科进行组织修复和器官再造常用的治疗方法之一,较大型扩张器有时会涉及到有毛区扩张,但在扩张皮肤转移进行组织修复和器官再造后又必须去除扩张皮肤的毛发,比如应用大型扩张器进行乳突区扩张耳再造及额部扩张进行鼻再造时,扩张皮肤区涵盖的有毛区皮肤,皮瓣转移后再脱毛往往比较困难。2007年1月～2010年1月,我们尝试运用Nd:YAG激光脱毛技术在置入扩张器前及皮肤扩张过程中进行脱毛治疗,取得了较好的治疗效果,现报道如下。
1资料和方法
1.1 一般资料:本组应用于皮肤软组织扩张期间脱毛治疗10例,其中耳部扩张皮肤耳再造5例,额部扩张皮肤鼻再造术5例。男6例,女4例,年龄8～26岁,平均为17.5岁。耳再造患者均为先天性小耳畸形,其中II度畸形4例,I度畸形1例;鼻再造患者均为外伤性鼻缺损,其中2例取肋软骨,1例取耳软骨移植。其中扩张器置入术前1周开始第一次脱毛治疗3例,扩张器置入术后10天开始脱毛治疗7例,脱毛次数平均为3.5次。
1.2 方法:治疗前首先画线标记皮肤扩张区,特别是涉及到有毛区进行明确标记,并对有毛区按毛发粗细密度等进行细化分别标示,每次治疗前剃毛备皮时避免皮肤损伤,清洁皮肤,对部分不能耐受疼痛的患者于治疗前1～2h涂利多卡因软膏以减轻脱毛疼痛。第一次脱毛可在扩张器置入手术前1周或扩张器置入手术拆线后即刻进行,为缩短脱毛治疗时间,每次治疗间隔4周。应用Coolide V型Nd:YAG激光系统进行脱毛治疗,激光波长1 064nm,光斑大小10mm,能量35～45J/cm2,脱毛前局部冰敷,涂冷凝胶 ......
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