Matsumura H, Engrav L H, Nakamura D Y, Vedder N B
Department of Surgery, University of Washington, Seattle, USA.
J Burn Care Rehabil. 1999 Jul-Aug;20(4):316-9. doi: 10.1097/00004630-199907000-00008.
Deep hand burns with exposed tendons and joints are rare but devastating injuries. They cannot be grafted and require flaps. Abdominal or groin flaps are commonly used, but they are bulky and require separation of the digits. We tried the Millard "crane" flap for these burns and compared our patients' results with those of patients who had received standard abdominal skin flaps. Eleven deep hand burns that had been treated with flaps were evaluated. Six patients had been treated with the crane flap and 5 had been treated with conventional abdominal skin flaps. All crane procedures provided graftable wound beds. The total active ranges of motion of all 11 patients 6 months after the surgical procedures showed no statistical difference. The crane method also provides good cosmetic results. None of the hands treated with crane flaps required procedures to separate the digits or debulk the flaps, but all of the hands treated with conventional abdominal skin flaps required these types of procedures.
伴有肌腱和关节外露的手部深度烧伤虽罕见但极具破坏性。此类烧伤无法进行植皮，需要采用皮瓣修复。腹部或腹股沟皮瓣是常用方法，但它们体积较大，且需要分指操作。我们尝试使用米勒德“鹤”式皮瓣治疗此类烧伤，并将我们患者的治疗结果与接受标准腹部皮瓣治疗的患者进行比较。对11例接受皮瓣治疗的手部深度烧伤患者进行了评估。6例患者采用了“鹤”式皮瓣治疗，5例患者采用了传统腹部皮瓣治疗。所有“鹤”式皮瓣手术均提供了可进行植皮的创面。术后6个月，所有11例患者的总主动活动范围无统计学差异。“鹤”式皮瓣法还能取得良好的美容效果。采用“鹤”式皮瓣治疗的手部均无需进行分指或皮瓣减容手术，但所有采用传统腹部皮瓣治疗的手部都需要此类手术。
