Al-Qattan Mohammad M
Division of Plastic Surgery, Department of Surgery, King Saud University, Riyadh, Saudi Arabia.
J Burn Care Res. 2009 Jul-Aug;30(4):616-9. doi: 10.1097/BCR.0b013e3181ac0298.
In Saudi Arabia, camping in the desert is commonly practiced by families. A campfire is usually lit and unsupervised crawling infants are at risk of burns from these campfires. During a 12-year period, a total of 53 children with hand contractures related to campfire burns were treated. The mean age at the time of burn was 9 months (range: 5-12 months). All patients presented with isolated palmar contractures of one (n=24) or both (n=29) hands. Surgical release and skin grafting were performed for a total of 82 hands. Full-thickness skin grafts from the groin area were used in mild cases, and thick split-thickness skin grafts harvested from the thigh were used in severe contractures. Graft take ranged from 90 to 100% "take" in all patients. Follow-up ranged from 6 months to 10 years. Recurrence of contracture was calculated for 30 children (52 grafted hands) who had follow-up for more than 5 years. Twenty hands (group I) had thick split-thickness skin grafts, and 10 (50%) of these required a second release and grafting procedure. The remaining 32 hands (group II) had full-thickness grafts and only 3 (9.4%) required a second release and grafting procedure. The difference was statistically significant (P=.003), indicating that group I are more likely to require secondary surgery on long-term follow-up.
在沙特阿拉伯，家庭在沙漠中露营很常见。通常会生篝火，无人看管的爬行婴儿有被这些篝火烧伤的风险。在12年期间，共治疗了53名因篝火烧伤导致手部挛缩的儿童。烧伤时的平均年龄为9个月（范围：5 - 12个月）。所有患者均表现为单只手（n = 24）或双手（n = 29）的孤立手掌挛缩。总共对82只手进行了手术松解和植皮。轻度病例使用腹股沟区的全厚皮片，严重挛缩则使用从大腿采集的厚中厚皮片。所有患者的植皮成活率在90%至100%之间。随访时间为6个月至10年。对30名随访超过5年的儿童（52只植皮手）计算挛缩复发情况。20只手（第一组）采用厚中厚皮片，其中10只（50%）需要二次松解和植皮手术。其余32只手（第二组）采用全厚皮片，只有3只（9.4%）需要二次松解和植皮手术。差异具有统计学意义（P = 0.003），表明第一组在长期随访中更有可能需要二次手术。
