张月 韩飞 官浩

    [摘要]目的：探討游离皮瓣联合预构扩张皮瓣修复面颈部大面积瘢痕的疗效。方法：2017年6月-2019年6月，应用游离皮瓣联合预构扩张皮瓣修复6例烧伤后患者的面颈部瘢痕。一期设计游离皮瓣修复颈部瘢痕的同时于前躯正常皮肤处设计预构扩张皮瓣，取长约10～14cm的旋股外侧动脉降支血管蒂作为预置血管，将扩张器及预置血管一同置入预扩张的皮瓣内。待扩张器扩张满意后，行二期手术，修复面部瘢痕。结果：分区(面部为一区，颈部为另一区)分次(一期修复颈部瘢痕及置入扩张器，待扩张器扩张满意后二期修复面部瘢痕)修复面颈部大面积瘢痕，两个皮瓣融合良好，未发生术后并发症。随访3～12个月，面部术区与周围皮肤色泽质地及厚薄均相近，张口及表情功能良好，下颌弧度接近正常，颈部活动得到明显改善，两处供瓣区仅留两条线性瘢痕。结论：游离皮瓣联合预构扩张皮瓣是修复面颈部大面积瘢痕较好的方法，供区损伤小，患者满意。

    [关键词]瘢痕;面颈部;预构扩张皮瓣;扩张器;游离皮瓣;分区修复

    [中图分类号]R619+.6? ? [文献标志码]A? ? [文章编号]1008-6455(2021)04-0078-03

    Repair of Faciocervical Scar with the Combination of Free Flap and Prefabricated Expanded Flap

    ZHANG Yue，HAN Fei，GUAN Hao

    (Department of Burns and Cutaneous Surgery，Xijing Hospital，Air Force Medical University，Xi'an 710032，Shaanxi，China)

    Abstract： Objective? To explore the effect of free flap combined with prefabricated expanded flap in the repair of large faciocervical scar. Methods? From June 2017 to June 2019， 6 patients suffered from faciocervical scars were included. Scars were repaired by free flap combined with prefabricated expanded flap. In the first stage ......