Tucker S C
Green Pastures Leprosy and Rehabilitation Hospital, Pokhara, Nepal.
Indian J Plast Surg. 2011 Jan;44(1):59-67. doi: 10.4103/0970-0358.81438.
An overview of a series of severe burn contractures in 44 hands reconstructed over a 20 month period with an easy to follow algorithm.
The series was carried out by a single surgeon at Green Pastures Rehabilitation Centre in Pokhara, Nepal. All patients attending with severe burn contractures to the hand were included in the series.
This is a retrospective review of burn contractures in a total of 44 hands. All the contractures involved limitation of movement by 60 degrees in two or more joints or by 80 degrees in one joint. The decision making process is presented as a flow chart indicating when and which flaps were used.
Illustrations demonstrate what was achieved, with all hands obtaining an improvement in function.
Although many of these contractures can be dealt with by skin grafting the series clearly illustrates the indications for flap coverage.
概述在20个月期间用一种易于遵循的算法重建的44只手的一系列严重烧伤挛缩情况。
该系列由尼泊尔博卡拉绿草地康复中心的一名外科医生完成。所有手部严重烧伤挛缩的患者均纳入该系列。
这是对总共44只手的烧伤挛缩情况的回顾性研究。所有挛缩均涉及两个或更多关节活动受限60度或一个关节活动受限80度。决策过程以流程图形式呈现，表明何时使用何种皮瓣。
插图展示了所取得的成果，所有手部的功能均得到改善。
虽然许多此类挛缩可以通过植皮处理，但该系列清楚地说明了皮瓣覆盖的适应症。
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