目的探讨额部瘢痕切除后创面的修复方法。方法按逆行设计原则,在患者上臂内侧无瘢痕,且肩关节、颈部活动无受限的情况下,在上臂外侧做切口,置入扩张囊;超量注水后,允分考虑瘢痕切除、松解后创面大小及扩张皮瓣回缩等问题,先行拟转移皮瓣延迟术。术后7d行额部瘢痕切除,皮瓣带蒂转移术。于3周后行皮瓣断蒂、舒平修复额部瘢痕切除后的剩余创面。结果本组共7例患者,均采用扩张后上臂内侧皮瓣带蒂转移术。术后皮瓣无血运障碍,效果良好。结论扩张后上臂内侧皮瓣是修复额部瘢痕切除后创面的较好选择。
Objective To investigate the repairing method of wound after frontal scar removal. Methods Before surgety, detailed physical examination should be peribrmed to make sure no scar at the region of medial upper arm and no limitation of' mobility of shoulder and neck. Following the principle of "planning in reverse", the soft tissue expander was implanted at the region of medial upper arm. Excessive filling of the expander was recommended. After thoroughly consideration of defect area and contraction of flap, flap delay was necessary to ensure the blood supply after flap transfer. The frontal scar excision and pedicle flap transfer were accomplished simultaneously at 1 week after flap delay and then skin flap pedicle division was carried out and the flattened flap was used to repair the rest part of impaired area at 3 weeks. Results Seven cases were performed with this method, all the cases were satisfied with the esthetic appearance without blood circulation disorder of the flap. Conclusion Pre-expanded medial upper arm flap is an ideal flap in treatment of frontal scar.