Wang K A, Wu G S, Sun Y, Xia Z F
Department of Burn Surgery, Institute of Burns, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China.
Zhonghua Shao Shang Za Zhi. 2017 Jan 20;33(1):58-61. doi: 10.3760/cma.j.issn.1009-2587.2017.01.016.
Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy. Excision of scars, release of muscle, joints or bones, and soft tissue transplantation are the core of surgery. Laser treatment has a bright future but still needs to be further studied. Additionally, some novel treatments such as molecular targeted therapy, cell therapy, fat injection, and botulinum toxin injection will play important roles in prevention and treatment of postburn contractures in the future. The purpose of this article is to review the literature concerning postburn contractures of the hand, and summarize the present situation of prevention and treatment of such disease comprehensively.
瘢痕挛缩畸形是手部烧伤后常见的并发症之一,可导致手部功能障碍和生活质量下降。手部烧伤后瘢痕挛缩的预防措施包括大片植皮、预防感染、坚持佩戴压力手套、使用硅胶片、佩戴矫形器、接受适当的物理治疗以及早期功能锻炼。手部烧伤后挛缩的主要治疗方法是手术、药物、激光治疗和康复治疗。瘢痕切除、肌肉、关节或骨骼松解以及软组织移植是手术的核心。激光治疗前景广阔,但仍需进一步研究。此外,一些新型治疗方法,如分子靶向治疗、细胞治疗、脂肪注射和肉毒毒素注射,在未来手部烧伤后挛缩的防治中将发挥重要作用。本文旨在回顾有关手部烧伤后挛缩的文献,并全面总结该疾病的防治现状。