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目的研究并探讨游离股前外侧穿支皮瓣修复烧伤瘢痕癌术后皮肤软组织缺损的临床效果。方法选取2011年6月~2016年1月深圳市龙岗中心医院收治的18例烧伤瘢痕癌术后皮肤软组织缺损患者,游离股前外侧穿支皮瓣对患者缺损的皮肤进行修复,观察患者的手术时间、术中出血量、术后并发症发生情况,并对比患者治疗前后的创面肉芽形态评分、疼痛评分、瘙痒评分、皮肤感觉恢复情况。结果 18例患者手术后皮瓣均有效成活,手术平均时间为(215.63±37.59)min,术中出血量为150~290ml,平均出血量为(219.83±36.54)ml。与治疗前相比,治疗后患者的创面肉芽形态评分、疼痛评分、瘙痒评分均明显改善(P<0.05)。与治疗前相比,治疗后患者的皮肤感觉恢复情况明显更佳(P<0.05),S4分级的病例数明显增多(P<0.05)。结论在烧伤瘢痕术后皮肤软组织缺损患者的临床治疗中,采取游离股前外侧穿支皮瓣进行修复,具有显著的治疗效果,可有效改善患者的皮肤缺损情况,缓解创面疼痛、瘙痒。
Objective To study and discuss the clinical effect of free anterolateral perforator flap for the repair of postoperative skin and soft tissue defects of burn wounds. Methods From June 2011 to January 2016, 18 cases of skin and soft tissue defect after burn scar cancer were treated in Longgang Central Hospital of Shenzhen City. The anterolateral anterolateral perforator flap was used to repair the defect in the skin of the patient. The operation of the patient Time, intraoperative blood loss and postoperative complications, and compared the wound granulation morphology score, pain score, pruritus score and skin sensation recovery before and after treatment. Results All the flaps of 18 patients survived effectively. The average operation time was (215.63 ± 37.59) min. The blood loss was 150 ~ 290ml and the average bleeding volume was (219.83 ± 36.54) ml. Compared with those before treatment, the wound granulation morphology score, pain score and pruritus score of patients after treatment were significantly improved (P <0.05). Compared with those before treatment, skin sensation recovery was significantly better (P <0.05) and S4 grade (P <0.05). Conclusion In the clinical treatment of patients with skin and soft tissue defect after burn scar surgery, the treatment with free anterolateral perforator flaps for repair has significant therapeutic effect, which can effectively improve the skin defect and relieve the wound pain and pruritus.