Voulliaume D, Mojallal A, Comparin J P, Foyatier J L
Service de chirurgie plastique et des brûlés, centre hospitalier Saint-Joseph-Saint-Luc, Lyon, France.
Ann Chir Plast Esthet. 2005 Aug;50(4):314-9. doi: 10.1016/j.anplas.2005.03.001.
Deep hand burns often leads to major deformities, involving cosmetic and functional disease as scar contracture, stiffness, or even amputation. Early surgical treatment and rehabilitation are always challenging but crucial in order to prevent burn sequelae. When tendinous, osseous, nervous or vascular component are involved, even hand vitality is engaged: cutaneous, fasciocutaneous, muscular or musculocutaneous flaps are then the only way of salvage for the hand. The purpose of this surgery is the early covering of essential components, allowing early rehabilitation and mobilisation. The problem remains the choice of surgical covering, according to the site, size, and depth of the burn, and local reliable opportunities. Care must be taken to preserve surgical ways for final sequela reconstruction.
深度手部烧伤常导致严重畸形，包括因瘢痕挛缩、僵硬甚至截肢引起的外观和功能问题。早期手术治疗和康复虽颇具挑战，但对于预防烧伤后遗症至关重要。当肌腱、骨骼、神经或血管成分受累时，甚至手部的活力都会受到影响：此时，皮瓣、筋膜皮瓣、肌瓣或肌皮瓣是挽救手部的唯一方法。该手术的目的是早期覆盖重要组织，以便尽早进行康复和活动。问题仍然在于根据烧伤的部位、大小和深度以及当地可靠的条件来选择手术覆盖方式。必须注意保留用于最终后遗症重建的手术途径。
