9ęඈඋ1࣏ۘऺ: Chinese Journal of Tissue Engineering Research www.CRTER.org වẴ ղཨḳඈඋÍŬƫƊǶ3Ǖʉ3äƫǜ☭ǎ ÖàϬ, (ƿම⎱(Əˋ͸ã͸½Ŝ́Ȼã½ɻpbŜ́ɕ`Ə̷KZhď 100144 ͂⑃ٸ (͂⑃ٸ)DOI:10.3969/j.issn.2095-4344.0147 ORCID: 0000-0002-3002-6055 তȷợⓉᪿ ղཨḳඈඋÍŬƫՈǕʉ ͓A0K˿K1991 ˝ÛK š£àěυďNKƏˋ ͼˈdzȋղཨḳඈඋÍŬ š͑ ͸ã͸½Zh̠˼͸ eƛäƫ ÍŬợòdzȋ3ÍŬղΧ☦ࢳʺ¤ ղΧPᄶ3 8ȀղΧäƫ3ृΓղΧäƫ3ƽʻƚä ½ Ŝ ́ Ȼã ½Ý Ÿ œ Ãồɳ]dzȋղ ƞòǎղཨĽɳ(ΞɯǕ)ţdz^ɬĐՈղཨĽ ƫ3¾ඊྡྷࢿΉäƫʐ,Ƨnj4 þKåKƶϙÎāɻp ཨḳඈඋÍŬ4 ‑ ղΧϬỘËͯ4 bŜ́ɕ`ΆΛƲ­Ρ ~2 řųÍŬղΧǚ̩͔P☦ղཨḳඈඋ෾ǃ 8ȀÍŬղΧ38ÍŬृΓղΧ38ȀÍŬृΓղΧ ȁ·ȔŀYūɣʏKœþK ࢴ&8ęśdž࿼94 Ʈt☦ࢳŰ̓3ƞòŰᑈՈÍŬղΧ ÖàϬᇇĐŰ&Ëͯ4 ƶQåK-ęKœþÛ ĕåKƏˋ͸ã͸½Ŝ ́Ȼã½ɻpbɕ`Ŝ L₎5 ́Ə̷KZhď ղཨḳඈඋÍŬƫ-ϬղཨḳඈඋÍŬÍŬղཨḳඈඋ ʺ¤ղཨḳඈඋₓϬzĿᜬȈᾬĹղཨḳඈඋ 100144 ෾ǃǚ̩4᪩5ͩඓƊr 30 ŅÀՈǕʉ >t&ϘƮ̲࢕Ոᢈǚ̩¯ɉ4╓؄ÍŬäƫՈǜ☭3ղΧᜄ੥ ᢧZᩨ᪊Ո¤3ƽʻƚäƫՈ·͑3¾ඊྡྷࢿΉäƫՈš͑ š͑ẝ̴ẟՈäƫȒ ūǣÍŬղΧƙȕ Ě ିǻ:R318 A:ۅŰ̓3ŰᑈՈ5ȕǕʉ dzὃ̹Ñnj͔ƞղΧႇྃ3]๒ᢆՈ෾ͥ ֲQ>Ϭz͔ᵯȈᾬĹղཨḳඈඋ෾ǃ Dzʃ᪊ Ոǚ̩4 ɘ4ěY2017-10-27 , Ⱥ8ȀղΧäƫ3ृΓղΧäƫ3ƽʻƚäƫ3¾ඊྡྷࢿΉäƫ਍^ղęśdž࿼ Öۘऺ້]) rřP8ȀÍŬղΧẟᜐ͔P☦ǚ̩ₑņäཨḳඈඋÍŬƫּ඗Ȍ ])ʺ¤ÍŬղΧՈᜄƇʐ☦ࢳ Ō ƫ ᝯࢴ&8ęśdž࿼9 ϵzղΧƞòᑈ3☦ࢳ̓ ࢿΉȒ̲ᢆ3£࿁ʮ̩ṇΙ Ąz^njղΧࢿΉǚ ̩ʐŎĿ☦ᾬࢿΉ5ͩ «ϘƮǚ̩̲࢕ₑᡅՈĿƚ,4 ʼᡅ ྐëղཨḳඈඋÍŬƫ«-ϬÍŬȭղཨḳඈඋẟᜐÍŬ ϣ8Q̲9ඈඋϬzĿᜬȈᾬĹ෾ǃՈǚ ₑņ ඓƊ 30 ŅÀՈǕʉ ֲQ>t&ϘƮ̲࢕Ոᢈǚ̩ₑņ5ͩ4̩ , ʉƗƦǡǕʉᱏÃ4Ոú2ղཨḳඈඋÍŬƫՈǕʉ3äƫǜ☭^ ÖàϬֲ 5ͩPubMed ϔǒß̼௦8tissue expansion tissue expander histology pre-expanded flap prefabricated flap perforator flap skin transplantation reconstructive surgical procedures9'L᪑ǎּ͟Ⴎϵ᪑ę ต̼௦8ղཨḳඈඋÍŬ ղཨḳඈඋÍŬƫ ඈඋƚ 8ȀղΧ ृΓղΧ ¾ඊྡྷࢿΉ ÖàϬ9ک ͟⏲᪑4̼͝௦4 4 189 ઋDz żඌ൷͑ 105 ઋň&dž໇Dz4 ղཨḳඈඋÍŬƫ^8ȀղΧäƫ3ृΓղΧäƫ3ƽʻƚäƫ3¾ඊྡྷࢿΉäƫ਍ּ඗Ȍ ඗Ș^඗᩾ dzƮt☦ࢳŰ̓ՈÍŬղΧ Í̓rǚ̩ᇇĐ ŌrřP8ȀÍŬղΧẟᜐ͔P☦ǚ̩ₑņäƫ ᝯࢴ &8ęśdž࿼9 Ąz^njŎĿ☦ᾬࢿΉ5ͩ «ϘƮǚ̩̲࢕ₑᡅՈĿƚ,4 ͟⏲᪑ ղཨḳඈඋÍŬƫ8ȀղΧඈඋƚඈඋȀņृΓղΧƽʻƚ¾ඊྡྷࢿΉղཨࢿΉŎĿ☦ᾬ ࢿΉƫǚ̩ₑņ ÖàϬ Huang Chang-jin, Master 'L᪑ candidate Physician, ղཨÍŬƫ̲࢕ղΧ¾ඊྡྷࢿΉǚ̩̲࢕¯ƫඈඋ1࣏ Department of Cervicofacial Plastic and Reconstructive Skin soft tissue expansion: history, development, technical revolution and Surgery, China Academy of application innovation Medical Sciences & Peking Union Medical College, Huang Chang-jin, Song Wei-ming (Department of Cervicofacial Plastic and Reconstructive Surgery, Plastic Surgery Beijing 100144, China Hospital (Institute), China Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China) Corresponding author: Abstract Song Wei-ming, Master, Chief physician, Professor, BACKGROUND: Skin soft tissue expansion is a common surgical procedure to grow extra skin through Master’s supervisor, controlled mechanical over-stretch, which has been extensively applied in the tissue repair and reconstruction of Department of Cervicofacial plastic surgery through more than 30-year development. Plastic and Reconstructive OBJECTIVE: To review the history, development, technical revolution and application of the skin soft tissue Surgery, Plastic Surgery expansion and to give prospects. Hospital, Chinese Academy METHODS: A computer-based online search was conducted in CNKI and PubMed databases using the keywords of Medical Sciences & of “tissue expansion, tissue expander, histology, pre-expanded flap, prefabricated flap, perforator flap, imaging Peking Union Medical technology, skin transplantation, reconstructive surgical procedures, stem cells transplantation, clinical College, Beijing 100144, application” in English and Chinese, respectively. A total of 4 189 articles were retrieved, and finally 105 eligible China articles were included. তේǻ:2095-4344(2018)08-01267-08 1267 .[,[Jƿම⎱. ղཨḳඈඋÍŬƫƊǶ3Ǖʉ3äƫǜ☭ǎ ÖàϬ ͂⑃ٸ ęඈඋ1࣏ۘऺ 2018 22(8):1267-1274. DOI:10.3969/j.issn.2095-4344.0147 RESULTS AND CONCLUSION: Skin soft tissue expansion, combined with prefabricated flap technique, perforator flap technique, imaging technology, and stem cell transplant, can build lager area of expanded flap, allowing us to repair more defected regions. Single prefabricated expanded flap is used in total facial reconstruction, known as “Chinese face shift”, which is better than the traditional allografts, marking a significant medical innovation in plastic surgery. Subject headings: Skin; Dilatation; Surgical Flaps; Stem Cell Transplantation; Reconstructive Surgical Procedures; Tissue Engineering 0 šᣄ Introduction Ƕ┨ʃβY ƗȧĝɻˬZ!ƗȧȅśΡ~Z"Ρ ͓ȉpȆŮĤĦĴKϝc͓ȉĤĦĴKĆŷ ͓ȉ ~ˍ`ˎðĝɻģZ#Ρ~ʬļ^Ræĝɻˬ3 pȆŮĤĦΦƂnŞ@͓ȉȆŮ˗Kȁˎƿŋ̧̇ĤĦ 1.3 ɩDό̥͑ŀ ɻˬͲ˼ƉƘͯʑnij ΦƿÅǠùξĤĦΦǠΊƋb͓ȉpȆŮY̓Ĥ ȔŀŷŻY̓E˺ƋKȁˎÇŸǝʐ˼ċϙK̖Ρ~ ĦKŶhùξĝ͓ȉpȆŮY̓ȆŮ͑ȧ˼ΦʪÜïĝ ʲĝˍ`^˵ʩΛΡ~Ɨȧĝɻģ3 940͙K(ijEÇ ƕǒƽ[1]3 Ÿ249͙ɻˬ.ɻKȋƔʼn105͙ɻˬY̓ŜŨǫʭ3 ͓ȉĤĦĴæǔźƀʖõKȃ˝ȁˎ^Ɔùξ$nʦ ƋƱ´Ϳȉ¸Y̓ĤĦ3džȻTÐðȬb͓ȉĝĤĦΛǟ 2඗ȘResults ̧ŀ͓ȉDZ>ĤĦ˫̈ϡƋĤĦΦĝƷʌuƖΣĨ3ɕˋ 2.1 ʠŧɿ̼ˣ ĤĦΦǫæõ̀˼DZ̓Į̀3DZ̓Į Ŝ́ȻãåNeumann[2]ȋê1957˝KhlΧĤ ̀ĤĦΦĆŶh˅ˍɒÙΟŋʳĔƛɞȆŮKĤĦΦ Ħ͓ȉ͑ȧƱĥbǫ4ƍKĄNeumannÛEɫηͫƷ ƯT̓ĮêĖĤĦ̚ˌ3Ɓ>DZ̓Į̀ĤĦΦ^͛ ĚȶΧĴ3Űƀ1976˝K˫õ͓ȉĤĦĴĝŇŞ¯öŀ ̢ͫƿÅKĄ9ΓĤĦŶſ˼ðϏ^õƅK͵ƪ̢æ ɕˋŜ́ȻãåRadovan[3]˼Ûʦ͸ɵiåSchulte ĕƁbȆŮ͂ŝKʛƲ­˫ºh3 ˾ȔΡƷijɩŇŞ),°ĝæõü͓ȉpȆŮĤ ʲνƲ­ƶϙøhæõ̀ĤĦΦ3æõ̀ĤĦΦn ĦΦ31979˝ÝɕˋŜ́Ȼãå͸ͮ(ASPRS)°[4]K͓ ĤĚ˅ƿŋ̧˼ĕʭȆfKKhðæɬ͛ϙͲô^ ȉĤĦĴĜĖŞümR˼ʴǏKh31982˝KRadovan[5] ȅ`Ƙ́ǑĝĤĦΦ3@hĝĤĦΦ́ǑuY Aǒ Ė˝ÝɕˋŜ́ȻãÖŽ°Ʒ2Ƥ58ŸKh͓ȉpȆŮ ́Żǒ́KƲ­°@hZ!́6́ȯµ́ ĤĦΦY̓lˮϝ̢lǔÜïDŸ3ƃ̢Radovan[3] ǵB́ġKĤĦ̢͓ȉ2ɻg6ɻKƏμĤĚȁȋɒK Argenta[6]Manders[7]Austadġ[8]ƗɲŜ́ȻãåƋ ƛɞĤĦȁĶϠKƗhlǔĤĦZ"×̵́ǺK ͓ȉĤĦĴĝƲ­KhY̓ƤQę31984˝͓ȉĤĦĴ ĤĦ̢Ȼ͓ȉĤĦȁîˍZ#µƸ́6Ƹ́K ¦nƏˋK1985˝ĦĬÛġ[9-10]ĖÉÝˋˍQę͓ȉĤĦ ƗhšŪ͓ȉĤĦZ$(́Kæh \bƗ 3 ĴÝ10Ÿ¶¬̢ Έ́͑ȧƏĝKh3͓ȉĤĦĴŃĄ ]˝įu͸ŀƋĤĦΦY̓ȷYKÉὰ̵ĤĦ ðõĝɧî¯ïĆŜ́ȻãƷĚö°ŪiW͇ĝfˌKl ΦY ş̇ĤĦΦYnĤĦΦ̇ǠˍĤĦĝbǫͮΊ ŵ30 ˝ĝƷĚK͓ȉĤĦĴ˫fɡŜ́ȻãȆŮ͑ȧ ͷÏbȆŮEϟϠºu̚ĤĦɻΊ[11]3ΆŃ˫̈K Ɨ ĝ@ʷƍƟĕƅ3 uΡ~ŀÉαÏɻóʹĬȑɑaĿĝş̇ĤĦΦK æϠºĤĦΦƋÏbȆŮĝΊͷKùξu̚ĤĦǠ 1ᰈʐ5ͩData and methods ΊKƒƃĤĦðϏKEϟ ΄ȁĤĦΦĤĦƗ15%20% 1.1 ºϗ̀ ijȔŀ tissue expansionKtissue ĝ͓ȉ[12-13]Z!˫ʋ˾QYˋȻ͸ŀɬ3D bʖ̀K expanderK histologyKpre-expanded flapKprefabricated ƅȔ͛ǑͿɑǑĝβ+Qijʖ̀Οβ+QijȆŮ flapKperforator flapKskin transplantationKreconstructive ĤĦΦ3Ý5 C ȶĤĦΦΊ̢ͬLsͬŜǑƧ ƀ surgical proceduresɡƶǝÅΛ˵ʩDZnÅϗƔ1956 37 C̈́rKΓ°û b́ǑæƯɃ.ͣȧ3Ρ~ŀ ˝ 1 Å ƀ 2017 ˝ 1 Å PubMed ļ ÿ (http://www.ncbi. ȶĤĦΦƂnƬƥb͓˗Kæ9ÛsͫĤĦſE ͓ȉp nlm.gov/pubmed)Z ͓ȉpȆŮĤĦΦK͓ȉpȆ ȆŮĤĦƀ§É́ǑKϠºĤĦðϏ˼Ɨ ĝ͓ȉ3ȶĤ ŮĤĦĴKȆŮ͸K§ʊ͓5K¤Ŧ͓5KȼˍF űK ĦΦæˏɡɫį͓ȉĤĦǜɺɯƗjˍɩ͇̼ͲôKΓ Ʋ­KhɡʩϧÅϗƔ1985˝1Åƀ2017˝1ÅƏˋ æ͇̓˼ôh͇uøY`ôκΛƲ­Ρ~ţô[14]3 ũɑ(http://www.cnki.net)3ʃϗƔĖ4 189͙ɻˬ3 2.2 ɓ`ʶ ĤĦ˅ɡ6ȑʗK9ÆĤĦhġÙ_ 1.2 1ƴÝe ȔɡƿÅKjÛŨΟŋ3nĤĦΦƋŶƗÅ9ς̊ ൷͑ʃβY ͓ȉpȆŮĤĦΦȆŮ͸§ʊ͓ Ēı~ɬŦưžʹ˼ý ġϘʦ'uÙȑȔhKĤĦ 5¤Ŧ͓5ȼˍF űƲ­Kh˵ʩĝɻˬZ! ˍξnŃ̜Ϙʦæ͇ȴÙKæ͇C͉ŀƿŋˎiƏĝǖ ĤĦ͓5Ρ~YĚ˵ʩĝɻˬZ"ȅDžˍͲô]ΉƷ ȍĦɃAȁƅͷ̊́f˼ˠɣGʗȅƒ[15-17]3 2˼Ý˺̷ΉÌ°Ʒ2ĝɻˬZ#^ȅɻˬʬļ^ 2.3 ɓ`ʠŧ͝ @hĝƿÅĤĦu˗Σƕ3 ƁKͲôʲνRæĝʬļ3 2.3.1 ΟðĤĦ ĴƏƲðĤĦK̇ĤĦΦˍΟéƿÅ 1268 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH Huang CJ, Song WM. Skin soft tissue expansion: history, development, technical revolution and application innovation. Zhongguo Zuzhi Gongcheng Yanjiu. 2018;22(8):1267-1274. 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Box 10002, Shenyang 110180 www.CRTER.org 1269 .[,[Jƿම⎱. ղཨḳඈඋÍŬƫƊǶ3Ǖʉ3äƫǜ☭ǎ ÖàϬ ͂⑃ٸ ęඈඋ1࣏ۘऺ 2018 22(8):1267-1274. DOI:10.3969/j.issn.2095-4344.0147 Ħ͓ȉɻΊįɃ.͑ȧ4ƍ? Ŧ͓5ɺ¸æÝĤĦ̢̓ɾ˾ͻʭĝsŦ űĴK ˋˍȻűƗ͸ŀƋƿŋƘ˼͓ȉĤĦɻΊĝα æîȎùξsŦ͓5Ɩˏ͑ȧĝɻΊ ƀǒƽY̓ƤΡ~u͸ŀǜhļ͸ ʖĝǒƽ 2.10 ϣˣʠŧŴÄ ƃǢIƘĤĦ§§ʊĤĦ͓5§§ ͯʑKĄȶǒƽ0ȧÖK˄ÝƲ­ȟʴKhBrobmann ĤĦ¤Ŧ͓5Λ¤Ŧ͓5ΧĴĝKh˼ƷĚKĤĦ͓5 ġ[63]ÝŦʦ͓ȉ°ɽ1.5 cm×1.5 cmĝǒɤKĤĦ̢ȁ LǢɯî§ɯJĝǒ̇ƷĚ ˎ !Ƙɔɩǒɤĝî̔įŖαɻΊShively[64]õ Σ˽ 2.10.1 §ʊĤĦ͓5 ÝʕŰ4ŦȭǼ̓ĝ͓ȉbɲK Îƀɼü%nαƀ·iͥƏKȁˎ4ɻΊæĜĖ͛ϙ̇ űnπ2ŦqȭͻʭķKűnͻʭķ͓5°uͻʭʆȁ ĤĦΦƏƿŋƘĄŃ̜ǒƽųˎdžȧK^ĉhƲ­ Ϳ̇Ȼ̵Ûķ̥ͻʭɑ́f§ʊỚ͓5KȅðÝȶ ű ǪÇ̼ġ[65-66]ͥʜǹB͑ȧɻΊ˼ƿŋƘʩˊĜK͑ ͻʭ˗ǚƂ͓ȉpȆŮĤĦΦKǕŸͻʭ̼̇ÏbƷĚK ȧɔ1 cm߲4ƍKȐb͛ƿŋ4.0 mLKɻb͛68 mLKp ĤĦ̢́fĤĦ)JĝỚ͓5Maitzġ [72] ˼The b1214 mLK ȼ46 mLKšŪ68 mLK. Üï Hoangġ[73]Ρ~2ʌKĤĦˎiƋ§ʊ͓5K^Wˏù 200300 mLK.Ʊĥ140160 mL˴̺Ǡġ[67]ȁˎÉ ξæŶhĝȆŮƘKƯϟ͆ˏÔY͓5ĝͻʭ̼KξŶ§ ɽ Ä U ĝ ǒ ƽ ǹ B ĝ ɻ Ί α ƀ ɼ ü Y ʊỜ͓5ĝˎiŃĆnĤĦˎiƏ9Ûb·̨Ί A=0.152V0.151KAĆ4ƍɻΊͿôε͑ȧɻΊ(cm2)K ſ4ͻ4φĝǰKÔYƤ§ʊͻʭĝ̵ÛͻʭÛA§