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劈裂厚度植皮术与多处Z成形术治疗腹股沟及会阴烧伤后挛缩的疗效：15年经验总结

Outcome of split thickness skin grafting and multiple z-plasties in postburn contractures of groin and perineum: a 15-year experience.

作者信息

Sajad Wani, Hamid Raashid

机构信息

Department of Plastic Surgery, SKIMS, Srinagar, Jammu and Kashmir 190011, India.

Department of Plastic Surgery, SKIMS, Srinagar, Jammu and Kashmir 190011, India ; Married Doctors Hostel, Block A, Room No. S2, SKIMS, Soura, Jammu and Kashmir 190011, India.

出版信息

Plast Surg Int. 2014;2014:358526. doi: 10.1155/2014/358526. Epub 2014 May 21.

DOI:10.1155/2014/358526
PMID:24967100
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4055381/
Abstract

Background. Groin and perineal burn contracture is a rare postburn sequel. Such postburn contractures causes distressing symptoms to the patients and in the management of these contractures, both functional and cosmetic appearance should be the primary concern. Aims. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postburn contractures of groin and perineum. Material and Methods. We conducted a study of 49 patients, with postburn groin and perineal contractures. Release of contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results. Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the contracture in 4 (8.16%) patients required secondary surgery. Conclusion. We conclude that postburn contractures of the groin and perineum can be successfully treated with release of contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary contractures of the graft and recurrence of the contracture.

摘要

背景。腹股沟和会阴烧伤挛缩是一种罕见的烧伤后遗症。此类烧伤后挛缩给患者带来痛苦症状，在这些挛缩的治疗中，功能和外观都应是首要关注点。

目的。研究腹股沟和会阴烧伤后挛缩的手术治疗（邮票植皮和多个Z成形术）效果。

材料与方法。我们对49例腹股沟和会阴烧伤后挛缩患者进行了研究。44例（89.79%）患者采用中厚皮片移植（STSG）松解挛缩，5例（10.21%）患者采用多个Z成形术松解挛缩并闭合创口。

结果。44例（89.79%）患者获得了满意的功能和外观效果。3例（6.81%）患者出现移植皮片轻度继发性挛缩，经物理治疗处理；4例（8.16%）患者挛缩部分复发，需再次手术。

结论。我们得出结论，腹股沟和会阴烧伤后挛缩通过挛缩松解后行邮票植皮可成功治疗，获得满意的功能和外观效果。术后不应忽视长期措施，如定期物理治疗、使用压力衣以及涂抹润肤霜按摩，应采取这些措施预防移植皮片继发性挛缩和挛缩复发。

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