目的 探讨采用髂腹股沟皮瓣修复小儿阴阜部瘢痕的效果.方法 自2016年1月至2020年10月,北京大望路急诊抢救医院烧伤整形科采用髂腹股沟皮瓣修复8例热烧伤后小儿阴阜部瘢痕挛缩畸形患儿.瘢痕增生时间6个月至3年;阴阜部瘢痕切除松解后继发裸露创面为8 cm×12 cm～10 cm×18 cm.8例患儿均采用单侧髂腹股沟皮瓣转移修复,供瓣区直接拉拢缝合或通过局部辅助接力皮瓣转移修复.术后用"人"字形支具固定双下肢于屈曲外展位,严格制动.结果 8例患儿皮瓣全部成活,瘢痕完全去除,畸形得到改善.随访6～12个月,生殖器回归正常生理解剖位置,皮瓣外形良好,无臃肿,质地柔软,颜色与受区接近,无挛缩,皮肤无炎症,未出现破溃,无继发瘢痕挛缩畸形,排便正常,患儿家属对手术效果满意.结论 通过一次手术采用髂腹股沟皮瓣修复小儿阴阜部瘢痕挛缩畸形,操作简单,疗效较好,有一定临床价值.

From May 2013 to March 2020, 25 patients with acute necrotizing fasciitis were admitted to Beijing Chaoyang Emergency Rescue Center, including 18 males and 7 females, aged 7 to 78 years. The lesions were mainly located in the lower extremities, with the original lesion areas ranging from 20 cm×15 cm to 83 cm×42 cm. After admission, comprehensive systemic treatment was performed, the lesion area was cut open and drained as soon as possible, and the necrotic tissue was removed. Vacuum sealing drainage was performed when the necrotic tissue in the wound was reduced. The wounds were directly sutured or repaired with thin split-thickness skin grafts taken from head and/or thigh or local skin flaps after the wounds were improved. The skin grafts and flaps survived well after surgery, and the wound was completely closed. None of the 25 patients had amputation. A total of 21 patients were followed up for more than half a year, showing no recurrence of acute necrotizing fasciitis and no difference in the function of their injured limb after the wound healing than before the onset.