The Clinical Study Of The Impact Of Skin Soft Tissue Expansion On The Proliferation Of Perforator Vessel

We often encounter patients with large area scar and deep ulcer of skin, local soft tissue defects which produced great harm to the patients’ physical and mental health in plastic surgery clinical work. With the quality of people’s life improved, they put forward higher requirement for the recovery of limb function and appearance of plastic. It’s a challenging subject of plastic surgery to achieve the recovery of soft tissue defect, functional reconstruction and improvement of appearance at a same time.It’s tend to consider using ortho position and distant skin flap to treat large soft tissue defect which due to the local tissue don’t have enough health skin flap to repair the defect, but this type of flap usually causes deformity of donor area and the appearance of flap seemed bloated. The result is difficult to live up to expectations. Now we use a method which combined the skin soft tissue expansion and perforator flap to fix these problems. Skin soft tissue expansion has been widely used in plastic surgery, and it’s become an important treatment in plastic surgery. The principle of this technique is by increasing the capacity of the dilator which produced mechanical tension on the surface of the skin, promoting cell proliferation of skin soft tissue, produced the "extra" skin to repair the defect. The expansion of perforators flap have some advantages such as lowing donor area defects, low tension suture zone, flap delay, promoting vascular hyperplasia, rich blood supply, thus it’s widely used in clinical.ObjectiveTo investigate the effect of skin soft tissue expansion on the proliferation of perforator vessel and to study the clinical effect of repairing large defect of hand and face with perforator flap according to curative effect. MethodsBetween February2006and February2012,18patients with large scars on face and upper limbs, and2patients with melanocytic nevus on hands were treated.3O days later, observing the diameter of perforator vessels from20patients in the light after the first-stage operation. We investigated the effect of expansion on the vascular diameter of flaps of some patients by CTA.ResultsTo detect the perforator vessel points on abdominal wall from20cases of patients with Doppler preoperatively. a total of345, and no obvious difference was found between the abdominal wall on both sides.nets of vessels in the flaps after the tissue expansion seen in the light.one months later, the diameter of perforator vessels increased. All flaps survived completely after the second-stage operation without vascular problems. The donor site and wound were healed by first intention.12patients were followed up for6to24months. The flaps appearance was satisfactory.ConclusionAfter the flaps had been expanded for a certain time, blood supply and the incisional area of the flap, and the necrosis rate of flaps are decreased. Perforator flaps angiogenesis could be enhanced by expansion. The satisfaction of patient as well as the clinical curative effect of the method is higher.