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纸质出版:2016
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王量,戴霞,李世荣,吕巍,王凡,刘林奇,沈洁,廖建贵,毋巨龙.Brent法与扩张法全耳再造术后并发症比较及Brent法术后并发症的防治[J].陆军军医大学学报(原第三军医大学学报),2016,38(16):1862-1867.
Wang Liang,Dai Xia,Li Shirong,Lyu Wei,Wang Fan,Liu Linqi,Shen Jie,Liao Jiangui,Wu Julong.Postoperative complications after Brent technique vs tissue expander technique of auricular reconstruction and prevention and treatment of those from the former technique[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(16):1862-1867.
王量,戴霞,李世荣,吕巍,王凡,刘林奇,沈洁,廖建贵,毋巨龙.Brent法与扩张法全耳再造术后并发症比较及Brent法术后并发症的防治[J].陆军军医大学学报(原第三军医大学学报),2016,38(16):1862-1867. DOI:
Wang Liang,Dai Xia,Li Shirong,Lyu Wei,Wang Fan,Liu Linqi,Shen Jie,Liao Jiangui,Wu Julong.Postoperative complications after Brent technique vs tissue expander technique of auricular reconstruction and prevention and treatment of those from the former technique[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(16):1862-1867. DOI:
目的 对Brent法全耳再造与扩张法全耳再造术后并发症进行比较分析。总结Brent法全耳再造术常见并发症,分析血肿、感染、支架外露的预防和处理方法。 方法 回顾性分析比较Brent法与扩张法全耳再造术后出现并发症的患者的临床资料。对Brent法并发症采用畅通引流、局部抽吸处理血肿,局部引流换药处理感染,换药、局部皮瓣转移、局部筋膜瓣加游离皮片移植覆盖外露支架。 结果 Brent法并发症发生率较扩张法低(P0.05)。其并发症经相应处理,血肿清除,伤口愈合,肋软骨支架外露覆盖。Brent法全耳再造术后支架外露多出现在一期术后4~6周,以耳后皮瓣前端与残耳组织结合部最常见,其次是耳轮后上缘交界处的外露。经过引流、换药、再次手术等处理,患者伤口均愈合,皮瓣及皮片存活。 结论 Brent法并发症发生率比扩张法低。Brent法术中需注意减轻皮瓣局部张力且术后密切观察转移皮瓣血运,采用换药、皮瓣转移或筋膜瓣联合皮片移植方式修复未愈创面。
Objective To analyze the differences in the postoperative complications between the Brent technique and tissue expander technique of auricular reconstruction
summarize the common complications of the former
and investigate on how to prevent and manage them
such as hematoma
infection
and framework exposure. Methods Clinical data of the patients who suffered from complications after auricular reconstruction with Brent technique or tissue expander technique in our department from October 2009 to October 2015 were collected and retrospectively analyzed in this study. For those undergoing Brent technique of auricular reconstruction
drainage and puncture were used to treat hematoma
dressing change and drainage were used for infection treatment
and dressing change
local skin flap and temporal superficial fascia flaps combined with split skin graft transplantation were used in the treatment of framework exposure. Results The incidence of complications was significantly lower in Brent technique than the tissue expander technique (P0.05). With the above mentioned managements
the hematoma was evacuated
the wound was healed
and the framework exposure was recovered. The framework exposure commonly took place within 4~6 weeks postoperatively. It occurred mostly in the junction of the mastoid skin flap and ear vestige
followed by the posteriorsuperior margin of the helix. After drainage
medication
surgery and other treatment again
wound healing and skin flap survival were observed in all the patients. Conclusion The incidence of complications is lower in the Brent technique than the tissue expander technique of auricular reconstruction. In the former surgery
clinicians should particularly reduce the tension of skin flap intraoperatively
and observe the blood supply of the flaps postoperatively. Dressing
skin flap transposition
or fascial flap combined with skin graft transplantation should be employed to heal the wounds.
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