欢迎来到OAJRC平台！

期刊栏目

投稿

审稿

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据：

当前位置：国际外科研究杂志 > 2022年 5卷 (4)期

Open Access Article

International Journal of Surgical Research. 2022; 5: (4) ; 1-4 ; DOI: 10.12208/j.ijsr.20220090.

Researchstatus of prevention and treatment of complications after expander postauricular flap for microtia
全扩张法治疗小耳畸形术后并发症防治的研究现况

作者： 陈思锦, 王继华 *, 张诗琴, 张景波, 汤婷, 张伯俊, 李姝蓉

昆明医科大学云南昆明

昆明医科大学第二附属医院整形外科云南昆明

*通讯作者：王继华,单位：昆明医科大学第二附属医院整形外科云南昆明；

2022年度云南省教育厅科学研究基金昆明医科大学2022年硕士研究生创新基金

发布时间: 2022-12-26 总浏览量: 924

PDF 全文下载引用本文万方数据（WANFANG DATA）

摘要

先天性小耳畸形是我国体表重大出生缺陷之一，目前耳廓再造术是修复小耳畸形最可靠的方法。软组织扩张技术是通过手术将软组织扩张器置入正常皮下或肌层下，通过扩张器不断扩张从而提供充分的皮肤软组织来修复较大的组织缺损或为组织填充、假体置入预留适当的空间。随着该技术在整形外科的广泛应用，应用软组织扩张技术治疗先天性小耳畸形已成为一种较成熟术式。皮肤扩张法耳再造术不仅很好地解决了耳廓再造术皮肤组织量不足、皮瓣血供障碍、减少瘢痕等问题，同时再造耳廓亚单位显示更佳清晰，形态更佳逼真，成为国内外主要的耳再造手术术式之一。但在临床工作中，经常发现在一期术后出现多种并发症，常见的有血肿、感染、扩张器外露等，严重影响二期、三期耳再造。现围绕全扩张法耳再造术一期扩张器埋置术后易出现的并发症出现的原因及防治措施进行综述，以期能为临床规范治疗提供参考。

关键词： 小耳畸形；全扩张法耳再造；并发症；预防与治疗

Abstract

microtia is one of the major birth defects in our country. Auricle rereconstruction is the most reliable method to repair microtia. The soft tissue expansion method is to place the soft tissue expander into the normal subcutaneous or muscular layer through surgery, and provide sufficient skin soft tissue through the expander to repair large tissue defects or reserve appropriate space for tissue filling and prosthesis placement. With the extensive application of this technique in plastic surgery, the soft tissue expansion technique has become a mature operation for the treatment of microtia. Auricle rereconstruction with skin expansion method can not only solve the problems such as lack of skin tissue, blood supply expander of flap and reduction of scar in auricle reconstruction, but also show better and clearer auricle subunits with more vivid shape, which has become one of the main auricle subunitssurgical methods at home and abroad. However, in clinical work, it is often found that there are a variety of complications after the first stage surgery, common hematoma, infection, expanderexposure, etc, which seriously affect the second and third stage auricle reconstruction. This article reviews the causes and prevention measures of complications after implantation of primary expanderin auricle reconstruction with expander postauricular flap method, in order to provide reference for clinical standard treatment.

Key words： microtia; expander postauricular flap; Complications; Prevention and Treatment

参考文献 References

[1] Luquetti DV,Heike CL, Hing AV, et al. Microtia: epidemiology and genetics[J]. Am J Med Genet A, 2012,158A(1):124-139.

[2] 郭蕊,王冰清,王悦,等.小耳畸形流行病学调查及危险因素列线图的建立[J].中华整形外科杂志, 2021, 37(6): 638-644.

[3] 蒋海越, 潘博, 林琳.先天性小耳畸形的分型及治疗策略[J].中华耳科学志,2013,11(4):476-480.

[4] 庄洪兴, 蒋海越, 潘博,等.先天性小耳畸形的皮肤软组织扩张器法外耳再造术[J]. 中华整形外科杂志, 2006, 22(4):4.

[5] 王璐,董立维,郭树忠,等.扩张法耳再造术预扩张方法探讨[J].中国美容整形外科杂志, 2016(4):3.

[6] 何乐人,林琳,王永振,等.八大处法耳廓再造二期手术并发症的处理[J].中华耳科学杂志, 2013, 11(4):5.

[7] Xing W, KangC, Yue W, et al.Reconstruction of Microtia Using a Single Expanded Postauricular Flap without Skin Grafting: Experience of 683 Cases[J]. Plastic and Reconstructive Surgery, 2018, 142(1):170-179.

[8] 陈淑强,马显杰.皮肤软组织扩张术后并发症的研究及防治现状[J].中国美容整形外科杂志,2019,30(02):124-125+130-131.

[9] Azzi,JL,Thabet, C, Azzi, Alain J, et al. Complications of tissue expansion in the head and neck. HEAD NECK-J SCI SPEC. 2019; 42 (4): 747-762. doi: 10.1002/hed.26017.

[10] Yu,Deborah,Toranto, et al. Endoscopic Vs. Open Tissue-Expander Placement: Is Less Invasive Better?: 85[J]. Economic Geology, 2015, 110(3):841-842.

[11] 李继洋,惠雷.立止血与皮肤软组织扩张术在老年烧伤整形患者中的临床疗效及安全性[J].中国老年学杂志,2015,35(02):398-399.

[12] 牟莉,吴启侠,姜海霞,等.扩张法外耳再造术常见并发症原因分析和护理对策[J].中华耳科学杂志, 2015, 13(1):4.

[13] 童韩,江李,王克华.导管外置式皮肤扩张术752例应用研究[J].中国美容医学 2015,24(3):1-4.

[14] 王璐,董立维,郭树忠,刘超华,郝冬月.扩张法耳再造术预扩张方法探讨[J].中国美容整形外科杂志,2016,27(04):206-208.

[15] 刘翔宇,刘宗辉,王璐,郭树忠.全扩张皮瓣法矫正小耳畸形一期手术的并发症分析及临床体会[J].中华整形外科杂志,2018,34(03):192-196.

[16] 楚菲菲,刘恒鑫,唐银科,等. 规范化耳后扩张器置入术在分期耳再造术中的应用分析[J]. 中国美容医学, 2018, 27(7): 32-35.

[17] 邹艺辉.耳后皮肤扩张器置入及常见并发症处理[J].中华耳科学杂志, 2014, 12(4):3.

[18] Cao TY,Zhang QG.Repair Exposure of the Postauricular Tissue Expander Using the Modified Brent Method: A 7-Year Experience.ENT-EAR NOSE & THROAT JOURNAL.2021：1455613211007967.

[19] Xing WS,Kang CY,Wang Y,et al.Reconstruction of Microtia Using a Single Expanded Postauricular Flap withoutSkin Grafting:Experienceof 683 Cases.PLASTIC AND RECONSTRUCTIVE SURGERY.2018;142 (1)：170-179.

[20] Zhang MY,Tian XC,Shi J,et al.Investigation of Microsurgical Technique Combined With Skin Flap Expansion for Ear Reconstruction in Treating Hunter Type III Congenital Microtia.ANNALSOF PLASTIC SURGERY.2017;78 (6)：680-683.

[21] Wang C, Lu X, Wei B, et al. Repair of damage to the skin flap during total auricular reconstruction with tissue expansion[J]. International Journal of Pediatric Otorhinolaryngology, 2020, 139:110470.

[22] 李旭文,章庆国,谢洋春,刘暾,周栩,韩雪峰.扩张法全耳再造皮瓣破溃后的处理[J].中华整形外科杂志,2012(01):16-18.

[23] Chen Q, Zhang J, Wang B, et al. Total Auricular Reconstruction Using a Single Extended Postauricular Flap Without Skin Grafting in Two Stages: Experiences of 106 Cases[J]. Aesthetic Plastic Surgery, 2019, 43(5).

[24] 刘翔宇,刘宗辉,王璐,郭树忠.全扩张皮瓣法矫正小耳畸形一期手术的并发症分析及临床体会[J].中华整形外科杂志,2018,34(03):192-196.

[25] 薛贵芝.皮肤软组织扩张器植入术的临床护理[J].上海护理,2008(03):28-29.

[26] Sun PF,Lu M,Wang CC, et al.A study on the therapeutic effects of biplane skin dilator implantation in auricular reconstruction.Scientific reports.2021;11 (1)：20532.

[27] 张伯俊,王继华,张景波,等.低位引流与切口引流对耳后扩张器置入后并发症的影响[J]. 中国美容整形外科杂志, 2020, 31(4): 212-214.

引用本文

陈思锦, 王继华, 张诗琴, 张景波, 汤婷, 张伯俊, 李姝蓉, 全扩张法治疗小耳畸形术后并发症防治的研究现况[J]. 国际外科研究杂志, 2022; 5: (4) : 1-4.

入驻平台

回到首页

搜索文章: