Chen Baoguo, Song Huifeng, Gao Quanwen, Xu Minghuo
The first hospital affiliated to the People's Literative Army Hospital, 51#, Fucheng Road, Haidian District, Beijing, 100048.
The first hospital affiliated to the People's Literative Army Hospital, 51#, Fucheng Road, Haidian District, Beijing, 100048.
J Pediatr Surg. 2016 Jul;51(7):1207-15. doi: 10.1016/j.jpedsurg.2015.12.006. Epub 2015 Dec 15.
Pediatric scar contractures in rapidly-growing regions require timely correction. Compared to flaps, skin grafts are characterized by scarring and retraction. More complex reconstructions are especially challenging in pediatric cases. Pedicled fasciocutaneous flaps are simple, durable, and able grow with the patient.
A series of 22 pediatric burn scar cases, with an average age of 6years, underwent treatment with pedicled fasciocutaneous flaps. They comprised 17 patients with scars involving the chest and axilla, and 5 patients with scars involving the groin and perineum.
Patient follow-up ranged from 3months to 2years, and included every patient. In total, 25 flaps were performed, comprising 4 lateral thoracic flaps, 5 superficial inferior epigastric artery flaps, and 16 scapular/expanded scapular flaps. Adjunctive skin grafts were used in 3 cases; the remaining 19 cases' donor sites were closed primarily. No flap loss or necrosis was observed.
Pedicled fasciocutaneous flaps are robust treatment options for burn scar contractures. Accompanied by tissue expander, it can be raised to repair larger area of contracture.
快速生长区域的小儿瘢痕挛缩需要及时矫正。与皮瓣相比,皮肤移植的特点是瘢痕形成和挛缩。更复杂的重建在小儿病例中尤其具有挑战性。带蒂筋膜皮瓣操作简单、耐用,且能随患者生长。
对22例平均年龄6岁的小儿烧伤瘢痕患者采用带蒂筋膜皮瓣治疗。其中17例瘢痕累及胸部和腋窝,5例瘢痕累及腹股沟和会阴。
对所有患者进行了3个月至2年的随访。共进行了25例皮瓣手术,包括4例胸外侧皮瓣、5例腹壁下浅动脉皮瓣和16例肩胛/扩张肩胛皮瓣。3例使用了辅助皮肤移植;其余19例供区直接缝合。未观察到皮瓣丢失或坏死。
带蒂筋膜皮瓣是治疗烧伤瘢痕挛缩的可靠选择。结合组织扩张器,可用于修复更大面积的挛缩。