中国现代手术学杂志2024，Vol.28Issue(2)：120-127,8.DOI:10.16260/j.cnki.1009-2188.2024.02.007
不同部位烧伤瘢痕癌的外科治疗策略
Surgical treatment strategies for Marjolin's ulcer in different locations:a retrospective analysis of 38 cases
摘要
Abstract
Objective To explore wound repair strategies for Marjolin's ulcer.Methods A retro-spective analysis was conducted on the clinical data of 38 patients with Marjolin's ulcer who were treated in our department over the past 10 years.Clinical data analysis,radiopathological diagnosis evaluation,and descrip-tion of surgical methods were performed.Outcome measures included surgical approaches,wound healing sta-tus,tumor recurrence,and survival rate.Results Among the 38 patients,there were 23 males and 15 fe-males,with a mean age of(53.63±9.74)years.The causes of the burns were flame burns in 32 cases and scald burns in 6 cases,with a mean latent period of(35.65±14.60)years.The lesions were located in the head(7 cases),lower limbs(18 cases),upper limbs(8 cases),trunk(3 cases),and face(2 cases).Pathological examination revealed 2 cases of basal cell carcinoma(superficial phenotype 1 case,infiltrating type 1 case;pathological grading:moderately differentiated 1 case,and highly differentiated 1 case)and 36 cases of squamous cell carcinoma(pathological grading:poorly differentiated 2 cases,moderately differentiated 10 cases,and highly differentiated 24 cases).Among them,35 patients underwent surgical treatment,with 6 patients undergoing amputation.Wound repair strategies included skin grafting(19 cases),local flaps(4 cases),and free flap transfer(6 cases).The median follow-up time was 2(2,3)years.30 patients had good wound healing without tumor recurrence,while 5 patients experienced tumor recurrence,with 3 undergoing subsequent surgical treatment.One patient died during the follow-up period,and 3 patients opted out of treatment and died during the follow-up period.Conclusion Wound repair strategies for Marjolin's ulcer should be personalized based on the tumor's location,nature,extent,and the overall condition of the patient,with early excision of the lesion being the key to treatment.Methods such as skin grafting,flap transfer,free flap transplantation,and amputa-tion can be used to repair the wound caused by Marjolin's ulcer.Surgical treatment can promote wound healing,but tumor recurrence remains a significant issue that requires further research and exploration.关键词
烧伤瘢痕癌/Marjolin溃疡/烧伤瘢痕/瘢痕溃疡/鳞状细胞癌/皮肤肿瘤/创面修复Key words
burn scar carcinoma/Marjolin's ulcer/burn scar/scar ulcer/squamous cell carcinoma/skin tumor/wound repair引用本文复制引用
赵筱卓,沈余明..不同部位烧伤瘢痕癌的外科治疗策略[J].中国现代手术学杂志,2024,28(2):120-127,8.基金项目
国家重点研发计划功能组织与器官体外精准制造技术与重建项目(2018YFA0703104) （2018YFA0703104）
国家重点研发计划"诊疗装备与生物医学材料"重点专项(2022YFC2403004) （2022YFC2403004）
