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目的探索以人工真皮加自体皮复合移植修复头皮皮肤癌切除术后大面积颅骨外露的手术治疗方式。方法 2011年8月-2013年1月6例头皮皮肤癌术后颅骨外露患者,一期以Mohs外科术式切除肿瘤组织,切除后外露颅骨组织颅骨电钻间隔0.5～1.0 cm钻孔,行人工真皮移植,3～4周后在新鲜肉芽组织上行二期自体皮移植术覆盖创面。结果 6例皮肤癌术后颅骨外露患者创面修复,皮片成活好,外观好,耐磨性好,不影响术后放射治疗,术后无复发。结论人工真皮加自体皮复合移植修复头皮皮肤癌切除术后大面积颅骨外露的方法具有风险较低、技术要求低、术后效果好的优点,是基层医院修复大面皮肤软组织缺损的较好选择。
Objective To explore the surgical treatment of large area skull exposed after artificial dermis and autologous skin grafting combined with grafting to repair scalp skin cancer. METHODS: From August 2011 to January 2013, 6 patients with scalp skin cancer were treated by Mohs surgical resection of the skull. Six days after the resection, the skull was excised with a 0.5-1.0 cm drill. The artificial dermis Transplantation, 3 to 4 weeks after the fresh granulation tissue up two phase autologous skin grafts cover the wound. Results 6 cases of skin cancer postoperative skull exposed patients with wound repair, skin survived, good appearance, good wear resistance, does not affect the postoperative radiotherapy, no recurrence. Conclusion The combination of artificial dermal autograft and autograft combined with autograft for the repair of large area skull after scalp skin resection has the advantages of low risk, low technical requirement and good postoperative effect. It is a good choice for primary hospital to repair large area soft tissue defect .