皮肤良性肿瘤手术切除后创面美容修复的探讨

目的:探讨皮肤良性肿瘤切除后创面美容修复的方法。方法:肿瘤病灶切除后根据创面部位、大小、深度,遵照"宁近勿远,宁简勿繁"的原则,选择适宜的皮瓣、肌皮瓣或皮片修复创面;创面位于功能部位者采用分区植皮技术。所有伤口局部均实施康复治疗。结果:皮片移植的721例中,684例自供皮区切取移植的中厚或全厚皮片成活率均在95%～100%;37例取自切除肿瘤组织表面皮肤的中厚皮片,27例成活率为70%～90%,10例经二期手术植皮愈合,该27例局部有瘢痕形成。166例采用各种皮瓣或肌皮瓣修复创面者,除2例皮瓣全部坏死,二期行皮片移植修复创面外,其余164个各种皮瓣均100%成活,161例术区外形与功能均满意。病灶摘除或切除后伤口直接缝合者230例中,伤口均一期愈合,226例局部无明显瘢痕增生与色素沉着。本组美容修复率达到96.8%。结论:采用美学理论和整形美容技术修复皮肤良性肿瘤切除后,创面可以达到美容修复的目的。

Wound cosmetic repair after excision of skin benign tumor

Objective：To study the wound cosmetic repair after excision of skin benign tumor.Methods： According to the site,area and depth of wound and the principle of ＂rather near than further,rather simple than complicated＂,a flap or a musculocutaneous flap or skin graft was employed to repair the wound after lesion was excised.If the wound located on function site,zonation grafting technique would be used.Local rehabilitation was carried out on wound.Results：Of 721 cases of receiving skin grafting,the survival rates of split-thickness or full-thickness skin grafts harvested from donor sites in 684 cases were 95% to 100%.The split-thickness skin grafts harvested from the removed tumor tissues were carried out in 37 cases,the survival rates of them in 27 cases were 70% to 90%,and operative repair on the second stage was carried out in ten cases.Scar formation appeared in those 27 cases.In 166 cases repaired by various skin flaps and musculocutaneous flaps,two skin flaps died fully and the wounds were repaired by skin grafting,and the other 164 flaps survived.Among them,satisfactory appearance and function appeared in 161 cases.The wounds were sutured directly after the lesions were removed in 230 cases,and the wound healed on the first stage.In those cases,there were no obvious scar formation and pigmentation in 226 cases.The rate of cosmetic repair was 96.8% in this group.Conclusion：The purpose of cosmetic repair would be achieved if theory of aesthetics and plastic and aesthetic technique are used after excision of skin benign tumor.