Ehrl Denis, Heidekrueger Paul I, Broer P Niclas, Erne Holger C
Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital Technical University Munich, Munich, Germany.
Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
J Burn Care Res. 2018 Jan 1;39(1):121-128. doi: 10.1097/BCR.0000000000000557.
Extensive partial- and full-thickness burns, especially of the hands, continue to pose a surgical challenge. With improved knowledge regarding fluid balance, burn pathophysiology, and lately also given the introduction of topical negative pressure wound (TNPW) therapy, treatment regimes have changed in many burn centers. The authors evaluated the results regarding long-term outcomes of patients with partial- and full-thickness burns of the hands treated with TNPW. Over a period of 72 months, 51 patients with 80 hand burns received TNPW treatment. Medical records of all patients were reviewed retrospectively. All patients were further invited by letter, telephone, and/or email to participate in follow-up examinations. Finally, 30 patients with 47 involved hands participated in this study. Follow-up examinations were performed at a mean of 35 (range: 14-72) months postinjury. Measurements regarding the ability to completely dorsally extend the fingers and complete active fist closure showed no restrictions in 85.1 and 78.7% of cases. Mean Disabilities of the Arm, Shoulder, and Hand score among all patients was 13.8 (range: 0-35.8). Regarding the quality of the scars of the hand, 41 hands showed good quality with no signs of hypertrophic scar formation and 6 hands showed acceptable quality of scars with partial hypertrophic scar formation. In the authors' experience, TNPW therapy is a safe and effective modality to treat burns of the hand.
广泛的部分厚度和全层烧伤，尤其是手部烧伤，仍然是一项外科挑战。随着对液体平衡、烧伤病理生理学的认识不断提高，以及近来局部负压伤口（TNPW）治疗的引入，许多烧伤中心的治疗方案已经发生了变化。作者评估了接受TNPW治疗的手部部分厚度和全层烧伤患者的长期预后结果。在72个月的时间里，51例患者的80只手接受了TNPW治疗。对所有患者的病历进行了回顾性审查。通过信件、电话和/或电子邮件进一步邀请所有患者参加随访检查。最后，30例患者的47只手参与了本研究。随访检查在受伤后平均35个月（范围：14 - 72个月）进行。关于手指完全背伸和完全主动握拳能力的测量显示，85.1%和78.7%的病例没有受限。所有患者的手臂、肩部和手部平均残疾评分是13.8（范围：0 - 35.8）。关于手部瘢痕质量，41只手瘢痕质量良好，无肥厚性瘢痕形成迹象，6只手瘢痕质量尚可，有部分肥厚性瘢痕形成。根据作者的经验，TNPW治疗是一种安全有效的手部烧伤治疗方式。
