Liang Liming, Chai Jiake, Jia Xiaoming, Wang Yirong, Meng Suyu, Liu Tao
Department of Burns and Plastic Surgery, First Affiliated Hospital, General Hospital of Chinese PLA, Beijing, 100048, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Dec;26(12):1486-8.
To investigate the effectiveness of repairing severe cicatricial contracture deformity in the web-space by kite-like incision combined with full-thickness skin grafting.
Between June 2008 and September 2011, 31 patients (87 web-spaces) with severe cicatricial contracture deformities in the web-spaces were treated. There were 24 males and 7 females, aged 5-43 years (median, 22 years). The causes of injuries were flame burn (26 cases), scald (3 cases), electric arc burn (1 case), and chemical burn (1 case). The degree of burn was deep second degree (14 cases) and third degree (17 cases). The interval time from injury to operation was 10 months to 17 years (median, 2.2 years). The kite-like incision was marked on the scar in the web-space. The rhombic scar between the adjacent metacarpophalangeal joints was excised, and cicatricial contracture was released completely. The secondary wound in the web-space was repaired with full-thickness autogeneic skin grafting. The secondary wound at donor site was directly sutured.
All full-thickness skin grafts survived well. The incisions at donor sites healed primarily. Of 31 patients, 29 (82 web-spaces) were followed up 6-18 months (mean, 13 months). The sizes and depths of reconstructed web-spaces were similar to those of normal ones. No secondary cicatricial contracture was observed, and the function of fingers recovered well.
The short-term effectiveness is satisfactory by kite-like incision combined with full-thickness skin grafting for repairing severe cicatricial contracture deformities in the web-space, while the long-term effectiveness needs further observation.
探讨采用风筝样切口联合全厚皮片移植修复指蹼严重瘢痕挛缩畸形的疗效。
2008年6月至2011年9月，对31例（87个指蹼）指蹼严重瘢痕挛缩畸形患者进行治疗。其中男性24例，女性7例，年龄5 - 43岁（中位数22岁）。致伤原因：火焰烧伤26例，烫伤3例，电弧烧伤1例，化学烧伤1例。烧伤程度为深二度14例，三度17例。受伤至手术间隔时间为10个月至17年（中位数2.2年）。在指蹼瘢痕上标记风筝样切口。切除相邻掌指关节间的菱形瘢痕，彻底松解瘢痕挛缩。指蹼处的继发创面采用全厚自体皮片移植修复。供皮区的继发创面直接缝合。
所有全厚皮片均成活良好。供皮区切口一期愈合。31例患者中，29例（82个指蹼）获6 - 18个月（平均13个月）随访。重建指蹼的大小和深度与正常指蹼相似。未观察到继发性瘢痕挛缩，手指功能恢复良好。
风筝样切口联合全厚皮片移植修复指蹼严重瘢痕挛缩畸形的短期疗效满意，长期疗效有待进一步观察。
