目的观察手术切除并应用自体结合异体真皮修复治疗颌面部皮肤恶性肿瘤老年患者的临床疗效。方法选择住院治疗的颌面部皮肤癌老年患者15例,其中皮肤鳞癌11例,基底细胞癌4例,患者均伴有不同程度的全身疾患。手术完整切除肿物,于同侧下颌骨下缘下方2~3 cm取梭型全层皮片,切成0.5 cm×0.5 cm小块,将组织块均匀铺洒于术区皮肤缺损,上方覆盖脱细胞异体真皮基质医用组织补片,边缘修整,再于上方覆盖油纱布,四周缝合后轻压包扎。术后处理局部创面与全身并发症。结果 15例患者术后创口愈合良好,未出现局部与全身并发症。术后随访8个月,无肿瘤局部及全身复发。治疗效果满意。结论对于颌面部皮肤恶性肿瘤老年患者,手术切除后应用自体真皮复合脱细胞异体真皮基质修复术后皮肤组织缺损,手术创伤小,患者术后恢复快,组织修复良好。
Objective To observe the curative effect of surgical excision combined with autologous skin grafting for the treatment of malignant tumor at maxillofacial region in elderly patients. Methods 15 patients with maxillofacial skin cancer were selected for this study,9 cases were males and 6 cases were females,with age range of 67 ~ 89 years old and average age of 78. 2 years old. Among them,11 cases suffered with skin squamous cell carcinoma,and 4 with basal cell carcinoma. All these patients had different degrees of systemic diseases. Complete surgical resection of the tumor,cut shuttle type whole layer skin piece at 2-3 cm below inferior border of mandible,cut into 0. 5 cm × 0. 5 cm pieces,then evenly spread on the operation area of skin defect,covered with acellular allogeneic dermal matrix patch from medical organization,trimming the edges,then covered with oil gauze around the suture after light pressure bandage. Results 15 patients with postoperative wound healing,there was no local and systemic complications. There was no tumor recurrence and local recurrence,after 8 months of follow-up. Clinical result is satisfactory. Conclusion For elderly patients with systemic complications suffering maxillofacial skin malignant tumor,after surgical resection of the tumor,autologous dermal acellular dermal matrix has been applied to repair the skin defect after operation. The surgical wound is small,the patient is quickly recovered,and the tissue is repaired well.