文章摘要
全世明,王昱,徐佳,等.烧伤后耳廓瘢痕畸形分级标准的设定[J].安徽医药,2021,25(7):1347-1349.
烧伤后耳廓瘢痕畸形分级标准的设定
Setting of the grading criteria for scar deformity of auricle after burn
  
DOI:10.3969/j.issn.1009-6469.2021.07.018
中文关键词: 烧伤  耳廓  瘢痕  参考标准  分级  整形
英文关键词: Burn  Auricular  Scar  
基金项目:国家卫生健康委能力建设和继续教育中心 2019年专项基金资助项目( GWJJ2019100303)
作者单位E-mail
全世明 北京中医药大学第三附属医院耳鼻咽喉科北京 100029  
王昱 北京中医药大学第三附属医院耳鼻咽喉科北京 100029  
徐佳 北京中医药大学第三附属医院普通外科北京 100029  
童德迪 北京积水潭医院手外科北京 100035  
温春泉 北京积水潭医院烧伤整形科北京 100035 siquan1760@sina.com 
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中文摘要:
      目的探讨烧伤后耳廓瘢痕畸形的严重程度的分级方法及对应的手术方式选择。方法对北京积水潭医院烧伤整形科 2008年 1月至 2017年 12月期间 165例烧伤后耳廓瘢痕畸形住院病例,进行回顾性统计分析。并按照病人耳廓瘢痕范围,耳廓位置与颅耳角有无异常,耳轮、耳垂、耳甲腔、耳屏等耳廓结构的缺损情况,耳廓结构的辨识度等几个方面,进行四级评级分类。并分析手术方式与烧伤后耳廓瘢痕畸形分级的相关性。结果一级轻度耳廓瘢痕畸形 74例,二级中度耳廓瘢痕畸形 51例,三级中重度耳廓瘢痕畸形 27例,四级重度耳廓瘢痕畸形 13例。一级轻度耳廓瘢痕畸形最常采用瘢痕切除术,二级中度耳廓瘢痕畸形最常采用瘢痕切除 +植皮术,三级中重度耳廓瘢痕畸形最常采用瘢痕切除 +局部皮瓣转移 +植皮术,四级重度耳廓瘢痕畸形最常采用瘢痕切除 +皮瓣转移 +植皮 +耳廓成形术。结论本研究首次建立烧伤后耳廓瘢痕畸形的分级标准,有利于畸形严重程度判断,并能指导手术方式的选择。此分级标准简单易行,适合在临床工作中推广应用。
英文摘要:
      Objective To explore the grading method of severity of auricular scar deformity after burn, and to selected corresponding surgical methods.Methods One hundred and sixty-five cases of auricle scar after burn in Department of Burns and Plastic Surgery, Beijing Ji Shui Tan Hospital from January 2008 to December 2017 were retrospectively analyzed. According to the range of scar,the abnormal cranioauricular angle, the defect of the auricle anatomical units such as helix, earlobe, cavity of auricular concha and tragus, and the identification degree of the auricle structure, four grades were classified. The relationship between the main surgical methods used in the operation and the specific grades of classification of auricle scar deformity were analyzed.Results There were 74 cases of first grade with mild scar deformity of auricle, 51 cases of second grade with moderate scar deformity of auricle, 27 cases of thirdgrade with moderate to severe scar deformity of auricle, and 13 cases of fourth grade with severe scar deformity of auricle. Scar excisionis the most common methods for the first-grade mild scar deformity of auricle. Scar excision and skin grafting are the most common methods for the second-grade moderate scar deformity of auricle. Scar excision plus local skin flap transfer and skin grafting are themost common methods for the third-grade moderate and severe scar deformity of auricle. Scar excision plus skin flap transfer plus skingrafting and auricular plasty are the most common methods for the fourth-grade severe scar deformity of auricle.Conclusion Establishing the classification standard of auricular scar deformity post burn is helpful to judge the severity of deformity and to guide the choiceof surgical methods. This grading criteria is simple and feasible, and suitable for clinical application.
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