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目的总结不同皮瓣一期修复头皮鳞状细胞癌术后缺损疗效。方法回顾分析1997年1月-2011年3月收治的44例头皮鳞状细胞癌患者临床资料。男32例,女12例;年龄36～65岁,平均45.2岁。病程1个月～2年。病变部位:额部7例,顶部27例,颞部8例,枕部2例。高分化鳞状细胞癌38例,低分化鳞状细胞癌6例。肿瘤切除后头皮缺损范围为5cm×4cm～27cm×11cm。33例缺损<10cm×8cm者采用大小为6cm×5cm～10cm×8cm的邻近头皮瓣移位修复,11例缺损>10cm×8cm者采用大小为11cm×9cm～28cm×12cm吻合血管的游离股前外侧皮瓣修复。供区采用游离植皮修复。术后正规放、化疗。结果术后2例皮瓣发生远端坏死,经换药后成活;其余皮瓣及供区植皮均成活,切口Ⅰ期愈合。放疗后皮瓣存活良好。30例患者获随访,随访时间2～3年,平均2.5年。皮瓣质地、颜色与周围正常皮肤相似,无局部臃肿。术后平均1.2年5例低分化鳞状细胞癌患者复发,其余患者肿瘤无复发,存活良好。结论根据缺损大小选择合适的皮瓣一期修复头皮鳞状细胞癌切除后缺损,均可获得较好疗效。
Objective To summarize the effect of different flaps in repairing the scalp squamous cell carcinoma after operation. Methods The clinical data of 44 patients with scalp squamous cell carcinoma admitted to our hospital from January 1997 to March 2011 were retrospectively analyzed. 32 males and 12 females; aged 36 to 65 years, mean 45.2 years old. Duration of 1 month ~ 2 years. Lesions: Department of forehead in 7 cases, the top 27 cases, 8 cases of temporal and occipital 2 cases. 38 cases of well differentiated squamous cell carcinoma and 6 cases of poorly differentiated squamous cell carcinoma. Scalp defect after tumor excision range of 5cm × 4cm ~ 27cm × 11cm. 33 patients with defect <10cm × 8cm were treated with adjacent scalp flap of size 6cm × 5cm ~ 10cm × 8cm, and 11 patients with defect> 10cm × 8cm were treated with free blood of 11cm × 9cm ~ 28cm × 12cm Anterolateral flap repair. For the use of free skin graft repair. Postoperative formal release, chemotherapy. Results 2 cases of distal necrosis of the flap occurred after dressing change, and the remaining flaps and donor grafts survived. The incision healed in the first stage. Flap survival after radiotherapy. Thirty patients were followed up for 2 to 3 years with an average of 2.5 years. Flap texture, color and normal skin around the similar, no local bloated. After an average of 1.2 years, 5 cases of poorly differentiated squamous cell carcinoma recurrence, the remaining patients with no recurrence of cancer, survived. Conclusion According to the size of the defect, a suitable flap can be used to repair the scalp squamous cell carcinoma after resection.