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目的探讨耳缺失整形修复中皮肤软组织扩张器破裂的原因及预防措施。方法回顾性分析2013年1月-2015年3月耳缺失修复患者行全耳再造皮肤软组织扩张器置入术后注水期间发生破裂的原因及预防措施,予加强健康宣教、辅以保护耳外套的应用、正确注水、总结经验并采取积极有效的预防措施等,以预防和减少皮肤软组织扩张器破裂的发生。结果 149例患者共153只患耳,使用皮肤软组织扩张器151只,皮肤软组织扩张器置入术后注水期间发生破裂7只,发生率为4.64%,其中有5只发生在注水后期,皮瓣大小接近预期,经取出扩张器立即行二期手术取得满意效果,另外2只发生在扩张器注水前期,因扩张皮瓣未达到预期条件,予以取出破裂扩张器,重新置入注水扩张,二期手术也获得满意效果。7例患者三期手术造型效果均较好。三期术后,所有患者随访3~6个月,均对手术效果非常满意,且无任何并发症发生。结论严格注水指征和方法并采取有效的健康宣教及预防措施可减少或避免皮肤软组织扩张器应用于耳缺失修复中破裂的发生。
Objective To investigate the causes and preventive measures of ruptured skin and soft tissue dilators in the treatment of otorrhaphy. Methods Retrospective analysis of the causes and precautionary measures of rupture during the water injection period from January 2013 to March 2015 in patients with auricular defect repair underwent total auricular reconstruction of soft tissue dilator for health education and health education Application, watering correctly, summarizing experience and taking active and effective preventive measures to prevent and reduce the occurrence of rupture of dermal soft tissue dilators. Results A total of 153 affected ears were used in 149 patients. A total of 151 skin and soft tissue dilators were used. There were 7 ruptures in the skin and soft tissue dilators during the watering period, with a rate of 4.64%, of which 5 occurred in the late stage of waterfilling. Flaps The size was close to the expected, and the dilator was removed immediately to obtain satisfactory results in the second stage of operation. The other two cases occurred in the early stage of dilator irrigation. The dilator flaps did not reach the expected conditions, and the ruptured dilator was removed and re-injected into the dilatation zone. Surgery has also been satisfactory results. Three patients in three surgical modeling results are better. After the third phase, all the patients were followed up for 3 to 6 months, all of which were very satisfied with the operation effect without any complication. Conclusions Strict indications and methods of water injections and effective health education and preventive measures can reduce or avoid the application of dermal soft tissue dilators in the repair of auricle defects.