Leman C J
Burn Rehabilitation Department, Washington Hospital Center, Washington, DC.
Clin Plast Surg. 1992 Jul;19(3):721-31.
Splints, exercise, traction, and compression garments are commonly accepted methods to minimize disabling scar formation. Although burn rehabilitation treatment has improved over the past 10 years, there is still no overnight cure for scars and contracture. The extent and depth of the burn injury, emotional strength and patience of the burn victim, and support systems available play an important role in scar treatment. Scar contracture is a frustrating complication for the recovering patient and burn team. Surgical reconstruction to correct functional impairment is often needed before wound maturation is complete. Splints are usually part of the postoperative treatment plan. When this is the case, patient understanding, compliance, motivation, and comfort are important to assure splint effectiveness. The treatments reviewed are specific for scar contracture limiting function of the upper body. Although they were presented as treatment of neck, mouth, axilla, and hand contractures, many of the principles and materials can be used after burn reconstruction of the lower extremities. Regardless of the area treated, assessment of patients is important to determine their specific needs in splint design.
夹板、运动、牵引和压力衣是普遍认可的可将致残性瘢痕形成降至最低的方法。尽管在过去10年里烧伤康复治疗有所改善,但瘢痕和挛缩仍然无法一蹴而就治愈。烧伤的范围和深度、烧伤患者的心理承受力和耐心以及可用的支持系统在瘢痕治疗中起着重要作用。瘢痕挛缩对于正在康复的患者和烧伤治疗团队来说是一个令人沮丧的并发症。在伤口完全成熟之前,通常需要进行手术重建以纠正功能障碍。夹板通常是术后治疗计划的一部分。在这种情况下,患者的理解、依从性、积极性和舒适度对于确保夹板的有效性很重要。所综述的治疗方法专门针对限制上身功能的瘢痕挛缩。尽管它们被介绍为颈部、口腔、腋窝和手部挛缩的治疗方法,但许多原则和材料可用于下肢烧伤重建后。无论治疗的是哪个部位,对患者进行评估对于确定他们在夹板设计方面的具体需求都很重要。