組織擴張器應用於燒燙傷疤痕的重建

燒燙傷疤痕重建的方法有疤痕修復，Z字成形術、皮膚移植、皮瓣轉移及自由皮瓣覆蓋等方法。近年來使用組織擴張術以為輔佐手術。不但愈來愈盛行，甚至已成為主要的重建手術方法之一。馬偕醫院整形外科近年來使用組織擴張器做各種疤痕的重建手術，收集兩年53例治療燒燙傷疤痕的經驗，雖然發現此一手術的許多優點：可獲一感覺、膚色、質感皆不錯的皮瓣；不會產生另一供皮區疤痕；手術簡單、迅速，可當天門診往返手術；可使用局部麻醉。但從此一早期的手術經驗發現全部病患發生較嚴重合併症者，共有15例，高達17.4%。分析15例發現合併症的發生與手術部位、病人年齡並無有意義的差異，但不同的醫師手術結果明顯不同，因此認為要避免此一高比率的併發症，主要取決於醫師的手術經驗：與病人的溝通及手術部位的選擇、擴張器植入時切口位置及方向的選擇、有無良好的止血與引流與手術後的感染有關。為要使此一手術達到最佳結果，手術醫師除應有相當詳細、完整的術前術後計劃，更須瞭解燒燙傷疤痕的特性。

關鍵字

組織擴張術；組織擴張器；貯存池

並列摘要

Tissue expansion is one of the most important improvements in current reconstructive surgical practice, especially in reconstructing scars resulting from burns. Fifty-three postburn scar cases were collected over two years at Mackay Memori1aosPital, The complications encountered in these patients are listed in Table 2. The complication rate was17.4%, and the most serious and common complication was infection that accompanied with the exposure of the expander, Good techniques and knowledge of possible complications are essential to maximize good results .Many complications are technically oriented, and so it is important to know how to successfully manage them, important features that require particular attention are the site and the direction of the incisions, the inflation technique, and the prevention of hematomas and infections. The incisions must be far from the expanded area, and should be radial to the inflating forces. Perioperative and postoperative antibiotics should be considereed to prevent infections. This tissue expanding procedure is considered to be an extraordinary cost effective technique, for the operation can be completed in the OPD using local anesthesia without any difficuity. In addition, the prosthesis can also be reused, and the expanded area re-expanded.

並列關鍵字

tissue expansion ； tissue expander ； reservoir

國際替代計量

組織擴張器應用於燒燙傷疤痕的重建

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