摘要
目的 探讨面部瘢痕切除缝合的原则。方法 回顾 1992至 1998年共行面部瘢痕切除缝合术 115 6例 ,其中以 11～ 40岁年龄段病例最多 ,共 10 5 0例 ,占总数 91%。分别采用直接切除缝合术、“Z”成形术、“W”成形术、分次切除术和即时扩张术等方法治疗。结果 临床共治疗 115 6例 ,效果满意。结论 面部瘢痕如顺皮纹可不做或少做“Z”成形术 ,需做“Z”成形术时 ,一般“Z”的臂长 1cm、夹角 6 0°左右为佳 ,且与轴线长度相等。“W”成形术对顺皮纹的线状瘢痕及早期缝合不佳留有针脚的瘢痕较适宜。对直径大于 2 .0cm的圆形瘢痕最好分次切除。一次切除张力较大的瘢痕可采用即时扩张术。同时术中注意剥离的范围及层次 。
Objective To investigate the principles for the suture of surgical wound in facial scar resection. Methods 1?156 patients underwent facial scar resection in our hospital from Dec. 1992 to Jul. 1998 were reviewed. Among them 1?050 were aged between 11 and 40 years accounting for 91% of the total. The patients were treated with resection and direct suture, 'Z' or 'W' plasty, fractional resection and instant dilation respectively. Results The 1?156 patients were treated with satisfactory results. Conclusion 'Z' plasty should not or rarely be performed on the facial scars in direction with cleavage lines. When needed, the 'Z' plasty should be done with preference of the 'Z' arm 1cm long, which is equal to the axial line, and the inclination of 60°. 'W' plasty is preferred for the linear scars with cleavage lines and scars with remnant stitches due to earlier faulty suture. Fractional resection is preferable for round scars with diameter of over 2.0cm. Instant dilation is used for one cut surgery of the scars with greater tension. Meanwhile, due attention should be paid to the extent and layer of stripping, and to the subcutaneous suture stitches which should be neither too much nor too dense.
出处
《实用美容整形外科杂志》
2001年第5期241-242,共2页
Journal of Practical Aesthetic and Plastic Surgery
