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目的:探讨皮肤恶性肿瘤和溃疡切除后的修复结果。方法:1994~2004年对28例皮肤恶性肿瘤和溃疡患者进行切除和病理学诊断,其中皮肤鳞状上皮癌10例,隆突性皮肤纤维肉瘤4例,皮肤原位癌3例,皮肤疣状癌2例,皮肤湿疹样癌4例,慢性恶性溃疡5例。手术后残留创面最大7 cm×12 cm,采用皮瓣、肌皮瓣游离植皮和直接缝合等方法进行修复,其中腓肠肌皮瓣2例,背阔肌皮瓣4例,足底内侧皮瓣4例,邻近皮瓣8例,游离大张植皮7例,肿瘤切除后直接缝合3例。结果:28例手术全部成功,切口一期愈合,19例获得随访,随访时间3~11年,14例术后恢复良好,2例局部复发,再次手术治愈,19例均成活。结论:彻底切除肿瘤是治疗皮肤恶性病变的关键,缺损的修复应根据病变的具体情况加以修复。
Objective: To investigate the results of resection of skin malignant tumor and ulcer after resection. Methods: Totally 28 cases of skin cancer and ulcer were diagnosed by pathological examination from 1994 to 2004. There were 10 cases of squamous cell carcinoma, 4 cases of dermatofibrosarcoma, 3 cases of carcinoma in situ, 2 cases of cancer, 4 cases of eczema like skin, 5 cases of chronic malignant ulcer. The residual wounds after operation were maximally 7 cm × 12 cm and were repaired by flap, myofascial flap free grafting and direct suture. Among them, 2 were gastrocnemius flap, 4 were latissimus dorsi flap, 4 were medial plantar flap , Adjacent flaps in 8 cases, free graft in 7 cases, direct resection of the tumor in 3 cases. Results: All the 28 surgeries were successful and the incisions healed in one time. Nineteen patients were followed up for 3 to 11 years. Fourteen patients recovered well after operation. Two patients had local recurrence and were cured again. All 19 patients survived. Conclusion: Thorough resection of the tumor is the key to the treatment of malignant skin lesions. Defect repair should be based on the specific conditions of the lesion.