耳后扩张皮瓣破溃的临床研究

胡守舵 赵延勇 杨庆华 蒋海越 庄洪兴

[摘要]目的：总结耳后扩张皮瓣破溃的常见临床情况。方法：回顾性分析自2003年1月～2006年10月，67例行耳廓再造、耳后扩张皮瓣破溃患者的临床资料,对其破溃的时间、部位、危险因素、破溃的过程、破溃的直接原因及破裂后的即刻处理方法等总结。结果：导致耳后扩张皮瓣破溃的危险因素包括皮瓣内部因素（约占21%）、外部因素（51%），另有约占28%的危险因素不明确者。危险因素不同者破溃的过程表现有异。结论：耳后扩张皮瓣破溃的原因和过程比较复杂，应予高度重视防患未然。

[关键词]耳后扩张皮瓣；破溃；临床研究

[中图分类号]R622[文献标识码]A[文章编号]1008-6455（2012）04-0560-03

Clinical study on the rupture of the postauricular expanded flap

HU Shou-duo1,ZHAO Yan-yong,YANG Qing-hua,JIANG Hai-yue,ZHUANG Hong-xing

（Plastic and Cosmetic Surgery Department of the Peking Hospital of Integrated Chinese with Western Medicine, Beijing 100039,China）

Abstract:ObjectiveTo summarize the clinical related situations about the rupture of the postauricular expanded flap.MethodsThe clinical data of 67 patients with the rupture of the postauricular expanded flap during auricular reconstruction from January 2003 to October 2006 were retrospectively analyzed. The related situations about the rupture such as the time, the common locations,the risk factors,the process,the direct causues, and the immediate treatments were studied.ResultsIn this series,the risk factors of the rupture included the internal factors (21%), the external factors (58%),and the unexplained factor (28%). The process of the rupture was different from each other according to the factors. Conclusions The situations about the the rupture of the postauricular expanded flap were complicated, more attention should be paid.

Key words:postauricular expanded flap; rupture; clinical study

耳后皮肤扩张法耳廓再造术因再造的耳廓形态逼真、自然，高度合适、效果完美而成为国内主流的外耳再造方法[1-4]，但是，扩张皮瓣破溃作为组织扩张术一项并发症[5-6]也是整形外科医生面临的、不可回避的问题。关于破溃的相关情况，目前尚未有相关报道，为此，笔者总结了2003年1月～2006年10月67例耳廓再造耳后扩张皮瓣破溃的临床情况，希望对同道有所帮助。

1临床资料

本组67例，其中男39例，女28例，年龄最小5岁，最大40岁，平均12岁。先天性小耳、无耳患者有60例，获得性耳廓畸形的患者有7例。本院60例，外院转入我科的7例。

2方法

2.1破溃分期：本研究将耳后扩张皮瓣破裂分为早期破溃和晚期破溃。早期破溃是指在注水扩张过程结束之前出现的耳后扩张皮瓣破溃，它包括注水前扩张皮瓣破溃和注水过程中扩张皮瓣破溃。……