Kalra G S, Bedi Mitesh, Barala Vipin Kumar
Department of Burns, Plastic and Reconstructive Surgery, SMS Medical College and HospitalJaipur, Rajasthan, India.
Int J Burns Trauma. 2017 Jul 25;7(4):50-55. eCollection 2017.
Large post burn scars are a very difficult problem to treat. Available methods include skin grafts and tissue expansion. The reconstructive method used should be tailored according to individual patient rather than following a textbook approach in each.
A retrospective analysis was done of cases with extensive facial burn scars in whom secondary reconstruction was done with either free parascapular flap cover or tissue expansion and flap advancement following facial burn scar excision by a single surgeon (GSK) in Department of Burns, Plastic and reconstructive surgery.
A total of 15 patients with free parascapular flap and 15 patients with tissue expansion followed by flap advancement were analyzed in the group. There were no free flap failures, but 2 patients required skin graft at donor site. In patients undergoing tissue expansion, minor complication was noted in 1 patient.
Tissue expansion is a useful technique in reconstruction of post burn scars, but has its limitations, especially in patients with extensive burns in head and neck region with limited local tissue availability. Parascapular free flap may provide a good alternative option for reconstruction in such cases.
大面积烧伤后瘢痕是一个很难治疗的问题。现有的治疗方法包括皮肤移植和组织扩张。所采用的重建方法应根据患者个体情况量身定制，而不是一概遵循教科书式的方法。
对烧伤、整形与重建外科的一位外科医生（GSK）治疗的面部广泛烧伤瘢痕患者进行回顾性分析，这些患者在面部烧伤瘢痕切除术后采用游离肩胛旁皮瓣覆盖或组织扩张加皮瓣推进进行二期重建。
该组共分析了15例采用游离肩胛旁皮瓣的患者和15例采用组织扩张加皮瓣推进的患者。没有游离皮瓣失败的情况，但有2例患者供区需要植皮。在进行组织扩张的患者中，有1例出现轻微并发症。
组织扩张是烧伤后瘢痕重建的一种有用技术，但有其局限性，特别是在头颈部广泛烧伤且局部组织可用量有限的患者中。在这种情况下，肩胛旁游离皮瓣可能为重建提供一个很好的替代选择。
