三种组织移植形式修复面部软组织凹陷对比研究

A Comparative Study of Three Forms of Tissue Grafting in Repairing Facial Soft Tissue Depressions

摘要: 目的：评价自体脂肪颗粒(Autologous fat granules, AFG)、真皮脂肪瓣(Free dermal fat, FDF)、脱细胞真皮基质(Acellular dermal matrix, ADM)三种不同方法移植修复面部软组织凹陷的临床效果。方法：回顾性分析2018年7月~2023年7月在昆明医科大学第二附属医院整形外科收治的29例面部软组织凹陷患者的临床资料，其中20例行自体脂肪颗粒移植，5例行真皮脂肪瓣移植，4例行异体脱细胞真皮基质移植。对比分析三组患者的手术时间、术后住院时间、术后疼痛视觉模拟评分(Visual analogue score, VAS)、患者的满意率及术后并发症的发生率。结果：29例患者术后面部形态与功能改善良好，三组在手术时间、患者满意率、术后并发症发生率方面没有显著差异(P > 0.01)。与其他两组相比，自体脂肪颗粒移植组术后住院时间最短(P < 0.05)，术后疼痛评分较其他两组高(P < 0.05)。自体脂肪颗粒移植组有1例患者术后出现发热，予清创换药及抗感染治疗后好转。真皮脂肪瓣与脱细胞真皮移植组无皮下硬结、感染等并发症发生。结论：三种组织移植形式在面部软组织凹陷修复方面均能取得良好的效果。

Abstract: Objective: To evaluate the clinical results of three different methods of grafting Autologous fat granules (AFG), Free dermal fat (FDF) and Acellular dermal matrix (ADM) for repairing facial soft tissue depressions. Methods: Clinical data of 29 patients with facial soft tissue depressions admitted to the Department of Plastic Surgery of the Second Affiliated Hospital of Kunming Medical University from July 2018 to July 2023 were retrospectively analyzed, among which 20 cases of autologous fat granules transplantation, 5 cases of free dermal fat transplantation ,4 cases of acellular dermal matrix transplantation were performed. The operation time, postoperative hospitalization time, postoperative pain visual analogue score (VAS), patient satisfaction rate and the incidence of postoperative complications were compared and analyzed among the three groups. Results: Twenty-nine patients had good postoperative improvement in facial morphology and function, and there were no significant differences among the three groups in terms of operative time, patient satisfaction rate, and incidence of postoperative complications (P > 0.01). Compared with the other two groups, the autologous fat granules transplantation group had the shortest postoperative hospitalization time (P < 0.05), and the postoperative pain score was higher than the other two groups (P < 0.05). One patient in the autologous fat granules transplantation developed postoperative fever, which improved after clearing and changing the wound and anti-infection treatment. There were no complications such as subcutaneous hardness and infection in the free dermal fat and acellular dermal matrix graft group. Conclusion: All three types of tissue grafts can achieve good results in repairing facial soft tissue depressions.