Gachie E, Casoli V
Service de chirurgie plastique-brûlés, centre François-Xavier-Michelet, CHU de Bordeaux, université Bordeaux-II-Victor-Segalen, place Amélie-Raba-Leon, 33076 Bordeaux, France.
Ann Chir Plast Esthet. 2011 Oct;56(5):454-65. doi: 10.1016/j.anplas.2011.09.003. Epub 2011 Sep 29.
Hand burns are common. Aesthetic and functional consequences are mixed together.
Palmar and dorsal skin are very different. Palmar skin is thick and strong, dedicated to the prehension. Dorsal skin is very thin, creating a mobility plan dedicated to the flexion of the fingers.
They are rarely isolated. Proximal nail retractions can occur after nail burns, with matricial exposition. We remove the scar and a full skin graft is done in order to give a normal proximal nail skin shape.
They are fingers and wrist retractions. We often use collagen substitute to cover soft tissue defect after scar excision. Commissure retractions are treated by trident plasty.
Electrical burns: we expose the case of a thumb amputation after necrosis by electrical burn, secondary treated by index policization. Children burns: the bridles appear during the growth, so we must follow this patient for a long time.
Hand burns are frequent. Functional sequelae are often important: retractions, amputations. The orthopaedic treatment of these retractions is unspecific. We often use collagen substitute in our unit. The patient must be involved in his treatment, because it is very long and difficult.
手部烧伤很常见。美学和功能后果交织在一起。
手掌和手背皮肤差异很大。手掌皮肤厚且坚韧，用于抓握。手背皮肤非常薄，形成了一个专门用于手指屈曲的活动平面。
它们很少单独出现。指甲烧伤后，伴有甲床暴露时，可能会出现近端指甲退缩。我们切除瘢痕并进行全厚皮片移植，以恢复近端指甲皮肤的正常形态。
表现为手指和手腕挛缩。我们经常使用胶原蛋白替代品来覆盖瘢痕切除后的软组织缺损。虎口挛缩通过三叉成形术治疗。
电烧伤：我们展示了一例电烧伤后拇指坏死并继发示指拇指化治疗的病例。儿童烧伤：在生长过程中会出现条索状挛缩，因此我们必须对这类患者进行长期随访。
手部烧伤很常见。功能后遗症往往很严重：挛缩、截肢。这些挛缩的骨科治疗并无特异性。我们科室经常使用胶原蛋白替代品。患者必须参与到治疗中，因为治疗过程漫长且困难。
