应用多个扩张器联合超量皮肤扩张术治疗先天性巨痣(1)
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[摘要]目的：探讨应用多个扩张器联合扩张皮肤软组织，并延长扩张时间、增加扩张量治疗先天性巨痣的临床疗效。方法：应用皮肤软组织扩张术修复躯干部巨痣9例，手术分两期进行。一期手术：在巨痣周围设计扩张器大小、形状及置入部位，扩张器容量为200～1000ml，扩张时间为3～6个月，扩张器结束时液体量为额度容量的2～5倍；二期手术：取出扩张器，切除巨痣，扩张皮瓣转移修复皮肤缺损。结果：扩张过程无1例出现扩张器因超量扩张出现破裂、渗漏，无出现血肿、感染、扩张器外露或注射壶渗漏等并发症。随访时间6个月到5年，患者术后的皮瓣颜色、质地佳，外观满意。结论：多个扩张器联合应用并延长扩张时间，增加注水量，可以产生更多的额外皮肤，修复躯干部先天性巨痣效果良好。
[关键词]扩张器；巨痣；皮瓣
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)02-0193-03
The treatment of giant congenital nevi by application of multiple expanders and overexpansion of Skin
CAI Xiang-na,LI Hong-sheng,JI Ying-chang,LI Yu,XU Hong-quan
(Department of Plastic Surgery,The First Affiliated Hospital of Shantou University Medical College,Shantou 515041,Guangdong,China)
Abstract: Objective To investigate the clinical effect of giant congenital nevi treated with skin soft tissue expansion by using multiple expanders,and prolonged injection time,increased solution volume. Methods 9 cases of trunk giant congenital nevi were treated with skin tissue expansion,this technique include two stages operation. The size,shape and implanting position of expanders was determined in the first stage. The expanders of 200ml to 1000ml were implanted into skin deep fascia and expanded for 3 to 6 months. At the end of the expansion,the injected solution volume was 2 to 5 times of the volume of expander. The expanders were removed,the giant nevi was excision and the expanded flaps were transferred to repair the defect in the second stage. Results No rupture or leaking of expanders happened in the management.None of patients got any complications including hematoma,infection,expander exposed or injection port leaking.Follow-up visit from 6 months to 5 years,the flaps were survived with excellent appearance,color and texture. Conclusion It was ideal clinical effect by using multiple expanders and prolonged injection time,increased solution volume which can bring more skin tissue than routine expansion to repair giant congenital nevi in trunk.
Key words:Expander;giant nevi;flap
巨型先天性黒色素细胞痣，简称巨痣，为皮肤的先天性肿瘤，其面积广大可分布在身体各处。巨痣不但致患者外形丑陋，对患者及其父母产生巨大的心理负担，而且还有恶变的可能。因此，手术是治疗巨痣的首选方法。对于巨痣的手术方法以往多以手术切除，创面游离皮片移植修复为主 ......
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