The Clinical Application Analysis Of Repairing Effects Of Faical Scar By Expanded Flap In Partition

Objective:Through the facial partition of patients,we chose suitable position of the skin to perform skin expansion,in order to repair the secondary defects after facial scar excision. Then the repairing effects were analyzed retrospectively, to explore the best methods of utilizing expanded flaps in every facial partition.Methods:From May 2005 to May 2015,170 cases with 198 parts of facial scars had treated in inpatient department of plastic surgery of the second affiliated hospital of kunming medical university-According to different facial scar in partitions,we chose different expanded skin flaps to repair, and analyzed retrospectively,including the scar area in every partition,the transfer methods,the appearance and function ratings of repairing effects.Then we use SPSS software to analyze,to compare the P values between ecah group by independent sample T-test.Results:There are in total 198 parts of facial scars,33 parts are on the forhead,85 parts are on the cheek,28 parts are around the mouth,52 parts on the nose.Among the 33 parts of forehead,the minimum scar area was 15cm2,the maximum scar area was 60cm2,20%-60%of the total forehead area, all were repaired by adjacent expanded flaps,including 15 advancement flaps,10 rotation flaps and 8 transpositon flaps,then we compared the the appearance and function scores,advancement flaps and rotation flaps:P= 0.002(P< 0.05), it was statistically significant;advancement flaps and rotation flaps:P=0.024 (P<0.05),it was statistically significant;rotation flaps and transpositon flaps:P=0.137(P>0.05),there was no obvious statistically significant,so the repairing effects of advancement flaps is better.Large scars of nose(more than 50% of its area) were treated by 46 expanded flaps of forehead and 6 expanded flaps of forearm.The appearance and function scores were compared between the two groups:P=0.00(P< 0.05).it was statistically significant,so the effect of frontal expanded flaps was better.The buccal scars were partly repaired by 42 faciocervical expanded flaps,the scar area was 20%-50%of the whole buccal area, the scars of more than 50%of the whole cheek area were repaired by expanded deltopectoral flaps and expanded free scapular flaps,comparing the appearance and function scores of the faciocervical expanded flaps and expanded deltopectoral flaps:P=0.019(P<0.05),it was statistically significant,faciocervical expanded flaps and expanded free scapular flaps:P= 0.039(P<0.05),it was statistically signiflcant,expanded deltopectoral flaps and expanded free scapular flaps:P=0.750(P>0.05),there was no obvious statistically significant,so the effects of faciocervical expanded flaps were better.The scars around the mouth were repaired by 20 expanded submental flaps and 8 expanded nasal groove flaps,the scores were compared between the two groups:P=0.028(P<0.05),it was statistically significant,so the expanded submental flaps were better.Conclusion:The first choice of surgical methods to repair facial large scars is expanded flaps,but repaireing by partition can get optimal appearance and funtion.The scar area among 20%-60%of frontal scar area prefer to frontal advancement flaps. The optimal choice to repair nasal large scars is frontal expanded flaps,following the forearm expanded flaps.The scars which are less than 50%of buccal area is better to repaired by expanded faciocervical flaps,more than 50%is expanded deltopectoral flaps or expanded free scapular flaps,the expanded submental flaps are the first choice to repair the scars around mouth.