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目的 探讨皮肤恶性肿瘤手术切除后的修复效果。 方法 1 984年～ 2 0 0 1年对 38例皮肤体表恶性肿瘤进行切取 ,其中皮肤鳞状上皮癌 1 2例 ,隆突性皮肤纤维肉瘤 1 4例 ,皮肤原位癌 2例 ,皮肤疣状癌 1例 ,皮肤湿疹样癌 4例 ,慢性溃疡恶变 5例 ;手术后残留创面最大为 1 4 cm× 2 0 cm。采用 7种不同类型的皮瓣、肌皮瓣、游离植皮和手术后直接缝合等方法进行修复 ,其中腓肠肌皮瓣 4例 ,背阔肌皮瓣 6例 ,阔筋膜张肌皮瓣 2例 ,腹直肌皮瓣 1例 ,足底内侧皮瓣 5例 ,邻近皮瓣 3例 ,游离大块植皮 1 2例 ,肿瘤切除后直接缝合 5例。 结果 38例手术全部成功 ,切口 期愈合。2 1例获得随访 ,随访时间 3～ 1 2年 ,1 9例术后恢复良好 ,2例术后局部复发 ,再次手术后治愈。 2 1例均成活。 结论 手术彻底切除肿瘤 ,修复方法应根据病情而制定 ,是根治皮肤恶性肿瘤的决定性因素
Objective To investigate the repair effect of surgical resection of skin malignant tumors. Methods From January 984 to 2001, 38 cases of skin surface malignancies were cut, including 12 cases of cutaneous squamous cell carcinoma, 14 cases of dermatofibrosarcoma of protuberance, 2 cases of cutaneous in situ carcinoma, and 2 cases of skin palsy. There were 1 case of carcinoma, 4 cases of skin eczema-like carcinoma, and 5 cases of chronic ulcer malignant transformation. The maximum number of residual wounds after surgery was 14 cm × 20 cm. Seven different types of flaps, myocutaneous flaps, free skin grafts, and direct sutures after surgery were used for repair, including 4 cases of gastrocnemius flap, 6 cases of latissimus dorsi flap, and 2 cases of tensor fascia flap. There were 1 case of rectus abdominis flap, 5 cases of medial plantar flap, 3 cases of adjacent flap, 12 cases of free massive graft, and 5 cases of direct suture after tumor resection. Results All the 38 cases were successful and the incisions healed. Follow-up was performed in 21 cases. The follow-up time was 3 to 12 years. 191 cases recovered well after surgery, and 2 cases had local recurrence and were cured after reoperation. All 21 cases survived. Conclusions The tumor should be completely resected after surgery. The method of repair should be based on the condition of the patient. It is the decisive factor in eradicating the malignant tumor of the skin.