鱼嘴形切口在色素痣分次手术切除中的临床应用
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摘要
目的:探讨鱼嘴形切口在色素痣分次手术切除中的临床应用效果。方法:对30例中小面积色素痣患者采用鱼嘴形切口进行分次切除治疗,每次间隔3～6个月,切除至皮损缩小到能够直接切除缝合。结果:本组30例色素痣患者采用鱼嘴形切口分次切除治疗后,术区切口均一期愈合,无并发症发生,随访6～18个月,无复发,皮损周围组织无明显牵拉变形现象,最终术区瘢痕不明显,视觉效果良好,医师与患者均对治疗后效果满意。结论:鱼嘴形切口在色素痣的分次切除中克服了传统梭形切口长宽比较大的缺陷,增加了皮损单次切除面积,减少了手术总治疗次数,操作方法相对简单,值得临床推广应用。
Objective To explore the significance of the clinical application of fish-mouth shaped incision used in fractional surgical resection of pigmented nevus. Methods Thirty patients with small and medium-sized pigmented nevus were treated with fish-mouth shaped incision. The interval of surgical treatment was 3 to 6 months. We keep using this operation till the lesion was small enough to take a direct resection. Results In this group, 30 patients with pigmented nevus were treated with fish-mouth shaped incision, all the incisions were healed in one stage without complications. After 6 to 18 months of follow-up,There was no recurrence or obvious deformation. The final scar in the operation area are not obvious, and the visual effect are great. Both the physician and the patient are satisfied with the treatment. Conclusion Fish-mouth shaped incision overcomes the shortcomings of traditional fusiformis incision, increases the single excision area of skin lesions, reduces the total number of operations, and it is relatively simple to operate. It is deserves to be promoted.
Objective To explore the significance of the clinical application of fish-mouth shaped incision used in fractional surgical resection of pigmented nevus. Methods Thirty patients with small and medium-sized pigmented nevus were treated with fish-mouth shaped incision. The interval of surgical treatment was 3 to 6 months. We keep using this operation till the lesion was small enough to take a direct resection. Results In this group, 30 patients with pigmented nevus were treated with fish-mouth shaped incision, all the incisions were healed in one stage without complications. After 6 to 18 months of follow-up,There was no recurrence or obvious deformation. The final scar in the operation area are not obvious, and the visual effect are great. Both the physician and the patient are satisfied with the treatment. Conclusion Fish-mouth shaped incision overcomes the shortcomings of traditional fusiformis incision, increases the single excision area of skin lesions, reduces the total number of operations, and it is relatively simple to operate. It is deserves to be promoted.
引文
[1]彭汉珍.复发性色素痣20例临床观察[J].中国美容医学,2012,21(18):216-217.
[2]Mutti LA,Mascarenhas M,Paiva J,et al.Giant congenital melanocytic nevi:40 years of experience with the serial excision technique[J].An Bras Dermatol,2017,92(2):256-259.
[3]陈积洪,李天武,傅跃先,等.手术治疗229例儿童黑色素痣临床效果观察[J].中国美容医学,2015,24(7):1-6.
[4]March-Rodriguez Alvaro,Lobato-Berezo Alejandro,Deza Gustavo,et al.The cake flap:a technique of serial excision in quadrants useful beyond congenital nevi[J].Int J Dermatol,2018,57:e138-e140.
[5]Paul SP.Biodynamic excisional skin tension lines for surgical excisions:untangling the science[J].Ann R Coll Surg Engl,2018,100(4):330-337.
[6]袁瑞红,魏韩笑,代晓明,等.面颈部色素痣不同手术切口疗效比较[J].昆明医科大学学报,2016,37(6):127-129.
[7]Kang HG,Park MC,Park DH.A new modality for treating congenital melanocytic nevus:"cogwheel pattern"serial excision method[J]Arch Plast Surg,2014,41(4):418-420.
[8]刘伟峰,刘斌,姜任武.皮内荷包缝合在分次切除面部色素痣中的应用[J].中华医学美学美容杂志,2016,22(3):185-186.
[9]Meissner M,Valesky EM,Kaufmann R.Subcutaneous non-absorbable polypropylene(SNAP)sutures in serial excision of congenital naevi:A new time-saving technique reducing dehiscence with optimized aesthetic results[J].J Eur Acad Dermatol Venereol,2016,30(3):533-535.
[10]张斌.三种手术治疗色素痣等类椭圆形皮损71例[J].中华皮肤科杂志,2014,47(6):409-412.
[11]顾子春,李华,叶学红,等.分次切除在皮肤病损治疗中的应用价值[J].全科医学临床与教育,2007,5(2):119-121.
[12]H?fner Hans-Martin,Breuninger Helmut.Serial excision with powerstretching of the skin in giant melanocytic nevi therapy[J].J Plast Reconstr Aesthet Surg,2018,71(3):443-445.
[13]张佳琦,张金明,梁伟强,等.皮肤扩张术在面部先天性巨型黑色素细胞痣治疗中的应用[J].中华医学美学美容杂志,2017,23(4):223-225.
[14]袁心刚,邱林,傅跃先,等.儿童面部黑色素痣诊治379例[J].临床小儿外科杂志,2016,15(2):170-174.
[15]翁胜涛,顾子春,李华.分次切除联合改形治疗面部瘢痕临床观察[J].中华皮肤科杂志,2018,51(2):145-147.
[16]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:450-452.
[17]Lida Naoshige,Watanabe Ayako,Kusano Taro.Usefulness of S-shaped incision in large nevussequential excision[J].Plast Reconstr Surg Glob Open,2014,2(10):e224.
[18]荀乙峰.锯齿状切口修复条形瘢痕[J].中国实用医药,2014,9(31):101-102.
[2]Mutti LA,Mascarenhas M,Paiva J,et al.Giant congenital melanocytic nevi:40 years of experience with the serial excision technique[J].An Bras Dermatol,2017,92(2):256-259.
[3]陈积洪,李天武,傅跃先,等.手术治疗229例儿童黑色素痣临床效果观察[J].中国美容医学,2015,24(7):1-6.
[4]March-Rodriguez Alvaro,Lobato-Berezo Alejandro,Deza Gustavo,et al.The cake flap:a technique of serial excision in quadrants useful beyond congenital nevi[J].Int J Dermatol,2018,57:e138-e140.
[5]Paul SP.Biodynamic excisional skin tension lines for surgical excisions:untangling the science[J].Ann R Coll Surg Engl,2018,100(4):330-337.
[6]袁瑞红,魏韩笑,代晓明,等.面颈部色素痣不同手术切口疗效比较[J].昆明医科大学学报,2016,37(6):127-129.
[7]Kang HG,Park MC,Park DH.A new modality for treating congenital melanocytic nevus:"cogwheel pattern"serial excision method[J]Arch Plast Surg,2014,41(4):418-420.
[8]刘伟峰,刘斌,姜任武.皮内荷包缝合在分次切除面部色素痣中的应用[J].中华医学美学美容杂志,2016,22(3):185-186.
[9]Meissner M,Valesky EM,Kaufmann R.Subcutaneous non-absorbable polypropylene(SNAP)sutures in serial excision of congenital naevi:A new time-saving technique reducing dehiscence with optimized aesthetic results[J].J Eur Acad Dermatol Venereol,2016,30(3):533-535.
[10]张斌.三种手术治疗色素痣等类椭圆形皮损71例[J].中华皮肤科杂志,2014,47(6):409-412.
[11]顾子春,李华,叶学红,等.分次切除在皮肤病损治疗中的应用价值[J].全科医学临床与教育,2007,5(2):119-121.
[12]H?fner Hans-Martin,Breuninger Helmut.Serial excision with powerstretching of the skin in giant melanocytic nevi therapy[J].J Plast Reconstr Aesthet Surg,2018,71(3):443-445.
[13]张佳琦,张金明,梁伟强,等.皮肤扩张术在面部先天性巨型黑色素细胞痣治疗中的应用[J].中华医学美学美容杂志,2017,23(4):223-225.
[14]袁心刚,邱林,傅跃先,等.儿童面部黑色素痣诊治379例[J].临床小儿外科杂志,2016,15(2):170-174.
[15]翁胜涛,顾子春,李华.分次切除联合改形治疗面部瘢痕临床观察[J].中华皮肤科杂志,2018,51(2):145-147.
[16]王炜.整形外科学[M].杭州:浙江科学技术出版社,1999:450-452.
[17]Lida Naoshige,Watanabe Ayako,Kusano Taro.Usefulness of S-shaped incision in large nevussequential excision[J].Plast Reconstr Surg Glob Open,2014,2(10):e224.
[18]荀乙峰.锯齿状切口修复条形瘢痕[J].中国实用医药,2014,9(31):101-102.