Ten-year experience in face and neck unit reconstruction using tissue expanders
Ten-year experience in face and neck unit reconstruction using tissue expanders
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DOI：
10.1016/j.burns.2012.07.020
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发表时间：
2013-05-01
期刊：
影响因子：
2.7
通讯作者：
Bakhshaeekia, Alireza
中科院分区：
文献类型：
--
作者：
Khalatbari, Behzad;Bakhshaeekia, Alireza
背景资料：组织扩张术通过使用相似的邻近组织来重建缺损而不产生显著的供体部位发病率，从而实现最佳的美学重建，特别是在面部和上颈部区域。方法：共有78例患者因烧伤瘢痕、创伤性瘢痕、Leschmaniasis或大色素痣而在脸颊或颈部插入组织扩张器（TE）进行面部重建。结果：所有重建均顺利完成;并发症包括：完全挤压（2.6%），不完全挤出（3.8%），部分坏死（14.1%），血肿（6.4%），瘢痕较宽（33.3%），增生性瘢痕（17.9%），下睑外翻（1.3%），扩张后萎缩（2.6%），永久性感觉减退（1.3%），下垂（14.1%）和感染结论：面部外侧区与颈部皮肤类型基本相同;因此，组织扩张允许通过使用相似的邻近组织和可互换地扩张下面部或颈部而进行最佳的美学重建，而不会产生主要的供体部位发病率;即使我们使用游离皮瓣来覆盖，虽然我们获得了良好的外形和足够的体积，但由于颜色匹配不佳，需要用扩张的皮肤重建上颈部以获得更好的效果。(C)2012 Elsevier Ltd和ISBI。All rights reserved.
Background: Tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue to reconstruct a defect without creation of significant donor site morbidity, especially in the face and upper neck area.Methods: A total of 78 patients underwent facial reconstruction by insertion of a tissue expander (TE) in the cheek or the neck due to burn scar, traumatic scar, leschmaniasis or large pigmented nevi.Results: All reconstructions were completed satisfactorily; complications were: complete extrusion (2.6%), incomplete extrusion (3.8%), partial necrosis (14.1%), haematoma (6.4%), wide scar (33.3%), hypertrophic scar (17.9%), lower lid ectropion (1.3%), post-expansion atrophy (2.6%), permanent decrement in sensation (1.3%), sagging (14.1%) and infection (2.6%).Conclusions: The lateral facial areas and neck contain essentially the same type of skin; hence, tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue and expanding either the lower face or the neck interchangeably without creation of major donor site morbidity; even when we use free flaps for coverage, although we achieved good contour and sufficient bulk, but due to poor colour match, reconstruction with expanded skin of the upper neck is needed for better result. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.