采用瘤体表面中厚皮片修复巨大皮肤良性肿瘤切除后创面(1)
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[摘要]目的：总结利用巨大皮肤良性肿瘤表面皮肤加工的中厚皮片修复其瘤体切除后创面的经验。方法：对1999年1月～2010年12月，我科收治的37例巨大皮肤良性肿瘤患者，在实施病灶切除后，利用鼓式取皮机的反鼓取皮技术，将瘤体表面皮肤加工成中厚皮片修复肿瘤切除后创面。结果：10例皮片成活率95%～100%，27例成活率为70%～90%，其中17例经换药愈合，10例经二次手术补充植皮愈合。所有病例术区外形良好，功能恢复满意，部分病例局部有少量瘢痕形成。结论：与取自正常皮肤的中厚皮片相比，此类皮片移植成活率稍低，但对于瘤体巨大，且位于非功能部位或相对隐蔽部位者，也不失为一种可供选择的修复方法。
[关键词]皮肤良性肿瘤；中厚皮片；创面修复
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)04-0538-03
Repair wound excised giant skin benign tumor with split-thickness skin graft harvested from tumor skin
LIU Yi,SONG Mei,XIAO Bin,LIU Pin,CHEN Lin-ing,XU Chen-xin,SONG Xiao-cheng
(Center of Burns and Plastic Surgery of CPLA,Lanzhou General Hospital of Lanzhou Command,Lanzhou 730050,Gansu,China)
Abstract: Objective To sum up the experience to repair wound excised giant skin benign tumor with split-thickness skin graft harvested from tumor skin. Methods From January,1999 to December, 2010, thirty seven patients with giant skin benign tumor were treated.The wounds excised giant skin benign tumor were coverred with split-thickness skin grafts which were harvested from tumor skin and manufactured by Padgett-Hood cutisentor. Results The survival rates of skin grafts reached from 95 percent to 100 percent in ten cases,and they were from 70% to 90% in 27 cases, among them, their wounds healed by dressing change in 17 cases and another operation was carried in ten cases. All cases showed good appearance and satisfactory function,and local slight cicatrization only appearred in a part of cases. Conclusion Compared with split-thickness skin graft from normal skin,the survival rates of those harvested from tumor skins might be lower, but it is a repair method to be selected for giant skin benign tumor located on nonfunctional or hinded positions.
Key words:skin benign tumor; split-thickness skin graft;wound repair
皮肤巨大良性肿瘤切除后创面大，要修复就需要切取较大面积的自体中厚皮片，从而导致供皮区瘢痕，此举与无创或微创等整形外科原则以及近年来所倡导的美容修复理念相悖[1]。鉴于此，1999年1月～2010年12月，笔者对收治的37例巨大皮肤良性肿瘤患者在实施病灶切除后，利用鼓式取皮机的反鼓取皮技术，将肿瘤表面皮肤加工成所需要的中厚皮片，并利用该皮片修复肿瘤切除后创面，取得了比较好的效果。
1 临床资料
1.1 一般资料：本组37例，男性24例，女性12例。年龄：3～35岁。肿瘤类型：神经纤维瘤18例，静脉畸形13例，毛细血管-静脉混合畸形6例 ......
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