本文選題：瘢痕攣縮 + 軟組織缺損�。� 參考：《中國修復(fù)重建外科雜志》2016年03期

【摘要】：目的探討應(yīng)用不同皮瓣修復(fù)手掌重度瘢痕攣縮畸形的療效。方法 2013年2月-2015年3月,收治手掌重度瘢痕攣縮畸形13例。其中男10例,女3例;年齡14~54歲,平均39歲。致傷原因:火焰燒傷、燙傷9例,熱壓傷2例,化學(xué)燒傷1例,電擊傷1例。傷后至手術(shù)時間為6個月~6年,平均2.3年。術(shù)中充分切除、松解攣縮瘢痕及粘連的深部組織,恢復(fù)各指至伸直位,軟組織缺損范圍為6.0 cm×4.5 cm~17.0 cm×7.5 cm。采用橈動脈逆行島狀皮瓣(2例)、腹部帶蒂皮瓣(4例)、游離胸背動脈穿支皮瓣(2例)、游離股前外側(cè)皮瓣(1例)、游離肩胛皮瓣(4例)修復(fù)創(chuàng)面;皮瓣切取范圍6.0 cm×4.5 cm~17.0 cm×7.5 cm。結(jié)果術(shù)后皮瓣全部成活。1例腹部帶蒂皮瓣出現(xiàn)遠(yuǎn)端血運(yùn)障礙,遠(yuǎn)端創(chuàng)面經(jīng)換藥后延遲愈合;其余患者創(chuàng)面均Ⅰ期愈合;供區(qū)植皮成活,切口均Ⅰ期愈合。13例患者均獲隨訪,隨訪時間6~14個月,平均8個月。8例患者接受1~3次皮瓣修薄術(shù)。末次隨訪時患者手部功能均明顯改善,外觀滿意。結(jié)論選用合適的皮瓣修復(fù)手掌重度瘢痕攣縮畸形能獲得較好的治療效果。
[Abstract]:Objective to investigate the effect of different flaps on the repair of severe scar contracture deformity of the palm. Methods from February 2013 to March 2015, 13 cases of severe cicatricial contracture deformity of palm were treated. Among them, 10 cases were male and 3 cases were female, the age was 14 ~ 54 years old with an average age of 39 years. The causes of injury were flame burn, burn in 9 cases, hot pressure injury in 2 cases, chemical burn in 1 case, electric injury in 1 case. The time from injury to operation was from 6 months to 6 years, with an average of 2.3 years. The deep tissues of contracture scar and adhesion were fully resected during operation, and the soft tissue defect was 6. 0 cm 脳 4. 5 cm~17.0 cm 脳 7. 5 cm 路cm. The wound was repaired by radial artery retrograde island flap (n = 2), abdominal pedicle flap (n = 4), perforator flap of dorsal thoracic artery (n = 2), free anterolateral femoral flap (n = 1) and free scapular flap (n = 4). Results all the flap survived. 1 cases of abdominal pedicled skin flap developed distal blood flow disturbance and delayed healing of distal wound after dressing change. All the other patients healed in first stage, donor skin graft survived, and 13 cases were followed up. The follow-up time was 6 ~ 14 months (average 8 months). At the last follow-up, the hand function was improved obviously and the appearance was satisfactory. Conclusion suitable skin flap can be used to repair severe scar contracture deformity of palm.
【作者單位】： 四川大學(xué)華西醫(yī)院燒傷整形科;
【分類號】：R658.2

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本文編號：2019055