Abstract: Objective To investigate the effect of multiple skin expansion on the efficacy and satisfaction of cicatricial plastic surgery after neck burn. Methods From February 2017 to March 2019, 60 patients with scar after neck burn were treated in our hospital. The patients were divided into 2 groups by random number table method, with 30 cases in each group. The control group received conventional flap repair, while the observation group received multiple skin expansion. The clinical efficacy, scar blood flow, pruritus, EGF, TNF-α, patient satisfaction and complications were compared between the two groups. Results The total effective rate of the observation group was 93.33%, which was higher than 73.33% of the control group (P<0.05). After operation, the blood flow value of scar and the score of pruritus in the two groups were significantly decreased, but the decrease of the observation group was more significant (P<0.05). After the operation, the EGF of the two groups increased significantly, but the increase was greater in the observation group. The TNF-α level of the two groups decreased significantly, but the decreasing range of the observation group was larger (P<0.05). The total satisfaction rate of the observation group was 90.00% (27/30), higher than 66.67% (20/30) of the control group (P<0.05). There were 3 cases (10.00%) in the observation group and 4 cases (13.33%) in the control group with no significant difference (P>0.05). The patients were followed up for 6 months after operation. Among them, 3 cases (10.00%) relapsed in the control group, and 1 case (3.33%) relapsed in the observation group. Conclusion The multiple expansion of skin can significantly improve the effect of scar plastic surgery, improve the blood perfusion and pruritus symptoms, increase EGF, reduce TNF-α level, and improve patients' satisfaction.

Key words: multiple skin expansion, conventional flap repair, neck, burn, scar reconstruction

摘要： 目的 探讨皮肤多重扩张对颈部烧伤后瘢痕整形疗效及满意度的影响。方法 选择2017年2月~2019年3月在我院接受治疗的60例颈部烧伤后瘢痕患者进行研究。采用随机数字表法将患者分为2组,每组各30例。对照组行常规皮瓣修复治疗,观察组采取皮肤多重扩张治疗。比较两组临床疗效、瘢痕血流值、瘙痒症状、EGF、TNF-α、患者满意度及并发症。结果 观察组总有效率为93.33%,高于对照组的73.33%（P<0.05）。术后两组瘢痕血流值及瘙痒症状评分均明显下降,但观察组下降幅度更大（P<0.05）。术后两组EGF明显升高,但观察组升高幅度更大。术后两组TNF-α水平均明显下降,但观察组下降幅度更大（P<0.05）。观察组总满意率为90.00%（27/30）,高于对照组的66.67%（20/30）（P<0.05）。观察组共出现3例（10.00%）并发症,与对照组的4例（13.33%）比较差异无统计学意义（P>0.05）。患者术后均随访6个月,其中对照组出现3例（10.00%）复发,观察组出现1例（3.33%）复发,两组差异无统计学意义（P>0.05）。结论 皮肤多重扩张较常规皮瓣修复治疗可明显提高颈部烧伤后瘢痕整形疗效,改善瘢痕血流灌注及瘙痒症状,升高EGF、降低TNF-α水平,提高患者满意度。

关键词: 皮肤多重扩张, 常规皮瓣修复, 颈部, 烧伤, 瘢痕整形