摘要
目的 探讨一种新的供皮区取皮方法,在获取较大面积全厚皮片的同时,可缩短供皮区宽度、减少缝合张力,供皮创面可直接拉拢缝合关闭.方法 运用数学原理,在面积相等的原则下,设计两个半圆相切排列的供皮法,所取的两个半圆皮片经拼接后即可形成一较大面积皮片,满足修复大面积皮肤缺损的需要.用该方法治疗9例皮肤恶性肿瘤患者,其中头、面部3例,足部6例,包括鳞状细胞癌3例,恶性黑素瘤6例.皮损面积1 cm×2 cm至6 cm×9 cm不等,切除后创面缺损面积为5 cm×6 cm至8 cm×9.5 cm.结果 供皮宽度缩小后,供皮区缺损能够直接拉拢缝合,同时也避免了供皮区皮源的浪费.头面部3例患者中,2例全部成活,1例边缘少许糜烂;6例足底部患者约有10％ ～ 20％坏死,经换药处理,1～2个月后愈合.结论 修复较大面积皮肤缺损,相切法等面积供皮是一种较好的选择.
Objective To develop a new method to gain large-sized full-thickness skin grafts,which allows the direct closure of donor defects by shortening the width of donor area and reducing suture tension.Methods According to mathematical principles,a method was developed to design two semicircular skin grafts which were tangentially joined to form a skin graft whose size was approximately equal to that of a large skin defect.This method was applied to treat 9 patients with cutaneous malignancy,including 3 cases of squamous cell carcinoma and 6 cases of malignant melanoma.Lesions were located on the head or face in 3 patients and in the foot region in 6 patients.The size of lesions varied from 1 cm × 2 cm to 6 cm × 9 cm,and the size of defects after resection of lesions varied from 5 cm × 6 cm to 8 cm × 9.5 cm.Results The width of donor areas was decreased by using this method,and donor defects were directly closed with the avoidance of waste of donor skin.Two out of three patients with carcinoma on the head or face achieved complete survival of skin grafts,and one experienced mild erosion at the margin of skin grafts.Skin graft necrosis （10%-20%） was observed in foot soles of 6 patients,which healed 1-2 months after dressing changes.Conclusion Equal-sized donor grafts formed by tangential joining of two semicircular skin grafts are a good choice for the repair of relatively large skin defects.
出处
《国际皮肤性病学杂志》
2015年第1期1-3,共3页
International Journal of Dermatology and Venereology
关键词
皮肤肿瘤
外科手术
皮肤移植
方法
Skin neoplasms
Surgical procedures,operative
Skin transplantation
Methods
